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Gastroenterology Report 2020年第2期8卷 83-84,I0001页

作者： octavi basssegoda Andres Cardenas GI/Liver Unit Institut de Malalties Digestives i MetaboliquesHospital ClinicUniversity of BarcelonaBarcelonaSpain Institut Dinvestigacions Biomediques August Pi I Sunyer(IDIBAPS) Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas(CIBEReHD)BarcelonaSpain

Portal hypertension in patients with cirrhosis is common and can lead to severe complications that are associated with decreased *** these complications,portal hypertensive bleeding and refractory ascites in many cases can be managed with the placement of a transjugular intrahepatic portosystemic shunt(TIPS).Current indications of TIPS placement include variceal hemorrhage refractory or recurrent to standard therapy with vasoactive drugs and endoscopic variceal ligation[1].Also,in carefully selected patients(***-Pugh class C cirrhosis with score 10-13 and Child Turcotte Pugh(CTP)class B with active bleeding on endoscopy),early TIPS(placed within 72 hours of admission)after vasoactive drugs and endoscopic band ligation improves *** intervention reduces the risk of rebleeding among this group of high-risk patients and is associated with increased survival[2].TIPS is also a treatment of choice in patients bleeding from cardiofundal varices(GOV2 and IGV1)and ectopic varices[1].Refractory ascites is also an indication for TIPS ***,its efficacy is controversial in this *** is clear that TIPS is associated with a better control of ascites than large-volume *** said,TIPS is followed by a greater incidence of hepatic *** results regarding the survival benefits of TIPS have emerged and are still a matter of intense debate[3].In summary,a careful selection of candidates for TIPS placement is necessary if refractory ascites is the indication for ***,TIPS can be detrimental in older patients with cardiopulmonary disease as well as in patients in CTP class C and higher Model for End Stage Liver Disease(MELD)*** has to be noted that most of the randomized trials evaluating survival of TIPS have been performed using bare stents[4].

关键词： refractory indication admission

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When Information Does Not Translate into Knowledge. Ebola and Hemorrhagic Fevers Knowledge among Primary Care Physicians and Nurses

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Open Journal of Preventive Medicine 2015年第3期5卷 122-127页

作者： Lluis Valerio Olga Perez-Quilez Silvia Roure Elisabeth Fructuoso Itziar Amilibia Nemesio Moreno Lydia Sanudo Cristina Bocanegra octavi Martinez-Cuevas North Metropolitan International Health Unit(PROSICS) Institut Catalade la SalutSanta Coloma de GramenetCataloniaSpain North Metropolitan Pimary Care Service Institut Catalade la SalutBadalonaCataloniaSpain North Metropolitan Primary Care Service Epidemiology and Technical DepartmentInstitut Catalàde la SalutSabadellCataloniaSpain

After the first secondarily-transmitted ebola case in Spain, a wave of divergent opinions flooded mass and sanitary media. Very few of these opinions, however, came from experts on epidemiology or hemorrhagic fevers. This observational study aimed to assess the specific knowledge of Primary Care physicians and nurses about ebola and hemorrhagic fevers by means of analyzing the results obtained from a 5-item self-reported questionnaire dealing on hemorrhagic fevers basic knowledge. Validity and reliability of questionnaire were confirmed by a pilot study. The participants were 138 family doctors and nurses from the 64 public Primary Care centers sited in the North Metropolitan Area of Barcelona (1,400,000 inhab;Catalonia, Spain) taking part in training-the-trainers ebola workshops. Overall, there were 117 (84.8%) respondents out from 138 workshop participants;of them were physicians 61 (51.2%). The main age was 46.7 (8.8) years;stating previous specific knowledge on hemorrhagic fevers 39 (33.3%). On the whole, up to 92 (78.6%) of respondents shown a poor knowledge. Previous specific formation was significantly and independently associated with having proper knowledge (p < 0.001);OR = 8.6 (CI 95%: 3.199 - 23.623). In summary, confusion that accompanied the single secondary-transmitted ebola case in Spain could probably be explained by the existence of a serious gap on hemorrhagic fevers knowledge. More accurate, scientific and formally-presented information should be provided to Primary Care physicians and nurses.

关键词： Ebola Haemorrhagic Fevers Primary Care Spain Nursing Knowledge

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