An Sist Sanit Navar
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An Sist Sanit Navar · Jan 2009
Case Reports[Persistent left superior vena cava. Implications in central venous catheterisation].
The placement of central catheters through the subclavian and jugular venous path can be complicated by the cannulation of an artery or an aberrant venous path. The most frequent anomaly of the embryological development of the caval vein is the persistence of the left superior vena cava (LSVC). ⋯ Diagnostic confirmation is obtained through angiography, echocardiography, computerised tomography or cardiac resonance. The doctor who regularly implants central venous catheters must be familiar with the anatomy of the venous system and its variants and anomalies, since their presence might influence the handling of the patient.
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An Sist Sanit Navar · Sep 2008
Review Comparative Study[Influence of dietary intake on plasma biomarkers of oxidative stress in humans].
Oxidative stress is related to an imbalance between the production of reactive species and the antioxidant defenses. In essence, oxidative stress has been defined as a disturbance in the pro-oxidant/antioxidant balance, leading to potential damage. It has been suggested that oxidative stress is involved in the etiology of several chronic diseases including cardiovascular disease, diabetes, cancer and neurodegenerative processes. ⋯ Most of the studies that have examined the association between diet and oxidative stress consider the effects of antioxidant supplements (vitamins and minerals), drinks and foods with bioactive compounds or dietary patterns on oxidative stress biomarkers. Some of these studies have demonstrated beneficial results on oxidative stress markers. However, the role of diet on oxidative stress biomarkers remains unclear and represents a potentially fruitful area for further research in the health area.
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An Sist Sanit Navar · May 2008
[Validation of the INFLESZ scale to evaluate readability of texts aimed at the patient].
The readability of written texts aimed at patients is an indicator of quality. Szigriszt made an adaptation of the RES Flesch Score, calling it "Escala de Nivel de Perspicuidad" (Clarity Level Scale), to measure the difficulty in reading a text. But Szigriszt used a text sample that was neither representative nor random, which is why the conclusions are not sufficiently consistent. The aim of this article is to complete the process begun by Szigriszt, review the Szigriszt Scale, comparing it with Flesch's scale, and propose a scale according to Spanish reading habits. ⋯ Only the scientific magazines are situated between 0 and 50. There are no publications with scores lower than 15. Szigrsizt locates "Normal" from 50; Flesch from 60. An intermediate position is adopted and a new scale is proposed: the INFLESZ Scale, which establishes 5 sections: "Very difficult" (<80), "Somewhat difficult" (40-55), "Normal" (55-65), "Quite easy" (65-80) and "Very easy" (>80). Neither the Clarity Level Scale of Szigriszt nor the RES Flesch Score are adapted to Spanish reading habits. In the case of texts on health, there is a greater probability of their being read and understood if they exceed 55.
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The choice of a venous access system to provide safe blood collection and reliable analytical results for that sample is of paramount importance in any accident and emergency department. The objective of this study was to identify the factors associated with haemolysis in venous blood samples, where the variables studied were: type of venipuncture (needle and catheter), type of catheter (3 catheters of 3 different materials) and diameter of the catheter. The sample was obtained from all patients who required a blood test in the accident and emergencies department of the Virgen del Camino Hospital over 34 days, collected in 3 different periods (September-November), involving a total of 1.933 procedures. ⋯ We observe an 8% (39/475) of haemolysis in the samples taken by protective Teflon catheter, 18% (77/426) by Protectiv plus polyurethane and 15% (106/684) by BD-Nexiva Vialone. The haemolysis index fell with an increase in the size of the catheter, those of 18G showing 13% (115/867) and those of 20G showing 15% (107/708). The combination of catheter type and size maintains the smallest percentages of haemolysis in Teflon catheters and high diameters of 18G with 6% (19/301), less than half the haemolysis of the polyurethane catheters and a third of that for Vialone catheters respectively.
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An Sist Sanit Navar · Jan 2008
[Patients with alteration of consciousness in the emergency department].
A subject is conscious when he is awake and with an adequate awareness of him and the environment. The term alteration of consciousness requires specification as to whether it defines alteration of arousal--when the patient might be confused, in a stupor or in some degree of coma (light, deep)--or alteration of awareness--that is, confused (spatio-temporally disoriented, with difficulty in maintaining his attention), with or without delirious ideation. The coma, in the strict sense, originates from structural (neurological) or functional (metabolic) dysfunction of the ascending reticular activator system, but it is accepted that it can derive also from diffuse bi-hemispheric cortical-subcortical damage. ⋯ Neurological exploration will specify the respiratory, pupil and ocular patterns and motor responses. The depth of the coma is established through scales; a simplification of Jouvet's scale is proposed. The etiological diagnosis will on occasion require image tests and lumbar puncture.