RESUMEN
OBJECTIVE: To describe the aspects with the greatest impact on the satisfaction of patients treated in a multidisciplinary unit specialising in immune-mediated inflammatory diseases (IMIDs) and to identify areas for improvement in the care model. METHODS: Cross-sectional descriptive study using a satisfaction survey structured in three blocks: sociodemographic variables, functional aspects of the unit and satisfaction with the professionals. Immediate satisfaction was measured on aspects related to the care received, the physical structure and the likelihood of recommending the unit. RESULTS: A total of 168 patients completed the surveys, the mean score of overall satisfaction with the unit was 4.75 (SD:0.4). The regression model showed the relationship between overall satisfaction and unit signage (OR:3.558, p=0.045, 95% CI: 1.027-12.33), coordination between professionals (OR:9.043, p=0.000, 95% CI: 2.79-29.28) and participation in decision making (OR: 44.836, p=0.000, 95% CI: 5.49-365.97). In terms of immediate satisfaction, the overall Net Promoter Score (NPS) was 87 (excellent). The mean score for coordination with Primary Care was 4.54 (SD:0.8) and they scored waiting time to be seen with 4.49 (SD:0.8), so they have been considered an area for improvement The mean score for coordination with Primary Care was 4.54 (SD:0.8) and they scored waiting time to be seen with 4.49 (SD:0.8), so both were considered areas for improvement. CONCLUSIONS: Coordination between intra-centre professionals and patient participation in decision-making explain the excellent level of patient satisfaction. The monitoring of satisfaction has made it possible to implement immediate improvement actions.
Asunto(s)
Satisfacción del Paciente , Humanos , Estudios Transversales , Masculino , Femenino , Persona de Mediana Edad , Adulto , Prestación Integrada de Atención de Salud , Anciano , Grupo de Atención al Paciente , Inflamación/terapia , Unidades Hospitalarias , Enfermedades del Sistema Inmune/terapiaAsunto(s)
Artritis Reumatoide/diagnóstico , Líquido Sinovial/química , Proteínas de Fase Aguda/análisis , Anticuerpos Antinucleares/análisis , Artritis Reumatoide/sangre , Artritis Reumatoide/orina , Autoanticuerpos/análisis , Biomarcadores/análisis , Coagulación Sanguínea , Remodelación Ósea , Citoplasma/inmunología , Femenino , Humanos , Masculino , Factor Reumatoide/análisisRESUMEN
Abdominal scintigraphy shows silent gut inflammation in patients with spondyloarthropathies (Sp) without clinical evidence of gut inflammation. Abdominal scintigraphy images are different than those obtained in patients with ulcerative colitis or Crohn's disease and are not related to the anti-inflammatory drugs administered. The aim of this study was to examine the clinical associations of findings on abdominal scintigraphy in patients with Sp. A total of 204 Sp patients (European Spondylarthropathy Study Group 1991 criteria) and 54 non-Sp controls receiving non-steroidal anti-inflammatory drugs were studied. Abdominal scintigraphy images were obtained at 30 and 120 min after injection of technetium-99m hexamethylpropylene amine oxime ((99m)Tc-HMPAO)-labelled leucocytes. (99m)Tc-HMPAO-labelled leucocyte scans were positive in 104 Sp patients (50.9%) and in six non-Sp controls (2.9%) (P<0.001; OR=8.32; 95% CI=3.23-22.67). Silent gut inflammation was not associated with any of the following: age of onset, duration of evolution, sex, family history of Sp or psoriasis, articular manifestations, extra-articular manifestations, radiological findings or HLA-B27 positivity. Positive abdominal scintigraphy was associated with active disease (P<0.0001; OR=52.7; 95% CI=19-145.6) and an increase in the C-reactive protein (P<0.005; OR=3.4; 95% CI=1.5-7.4). It is concluded that (a) abdominal scintigraphy using (99m)Tc-HMPAO-labelled leucocytes is of value in detecting the silent gut inflammation in Sp patients, and (b) silent gut inflammation is related to the clinical activity, but is not associated with any particular type of illness or with HLA-B27.
RESUMEN
Abdominal scintigraphy shows silent gut inflammation in patients with spondyloarthropathies (Sp) without clinical evidence of gut inflammation. Abdominal scintigraphy images are different than those obtained in patients with ulcerative colitis or Crohn's disease and are not related to the anti-inflammatory drugs administered. The aim of this study was to examine the clinical associations of findings on abdominal scintigraphy in patients with Sp. A total of 204 Sp patients (European Spondylarthropathy Study Group 1991 criteria) and 54 non-Sp controls receiving non-steroidal anti-inflammatory drugs were studied. Abdominal scintigraphy images were obtained at 30 and 120 min after injection of technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO)-labelled leucocytes. 99mTc-HMPAO-labelled leucocyte scans were positive in 104 Sp patients (50.9%) and in six non-Sp controls (2.9%) (P<0.001; OR=8.32; 95% CI=3.23-22.67). Silent gut inflammation was not associated with any of the following: age of onset, duration of evolution, sex, family history of Sp or psoriasis, articular manifestations, extra-articular manifestations, radiological findings or HLA-B27 positivity. Positive abdominal scintigraphy was associated with active disease (P < 0.0001; OR=52.7; 95% CI=19-145.6) and an increase in the C-reactive protein (P < 0.005; OR = 3.4; 95% CI = 1.5-7.4). It is concluded that (a) abdominal scintigraphy using 99mTc-HMPAO-labelled leucocytes is of value in detecting the silent gut inflammation in Sp patients, and (b) silent gut inflammation is related to the clinical activity, but is not associated with any particular type of illness or with HLA-B27.
Asunto(s)
Abdomen/diagnóstico por imagen , Leucocitos/diagnóstico por imagen , Radiofármacos , Espondilitis/diagnóstico por imagen , Exametazima de Tecnecio Tc 99m , Adulto , Antiinflamatorios no Esteroideos/uso terapéutico , Femenino , Antígeno HLA-B27/análisis , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Persona de Mediana Edad , Cintigrafía , Espondilitis/tratamiento farmacológico , Espondilitis/inmunologíaRESUMEN
UNLABELLED: The frequency of anti-U1-RNP and anti-Sm antibodies in systemic lupus erythematosus (SLE) varies according to the technique used for their detection. OBJECTIVE: To study the clinical manifestations associated with anti-U1-RNP and anti-Sm antibodies identified by different techniques. METHODS: 112 patients diagnosed with SLE were studied. Anti-U1-RNP and anti-Sm antibodies were detected by ELISA with a mixture of recombinant antigens, antigens obtained by immunoaffinity and by immunoblotting and counterimmunoelectrophoresis (CIE) with a saline extract of rabbit thymus. RESULTS: Anti-U1-RNP antibodies were detected in 70 (62.5%), 37 (33%) and 16 (14.2%) patients, and anti-Sm antibodies in 43 (38.3%), 36 (32.1%) and 10 (8.9%) patients by ELISA, immunoblotting, and CIE, respectively. Anti-U1-RNP antibodies are associated with edema in the dorsal hand region, sclerodactylia, Raynaud phenomenon and pericarditis (CIE); arthritis, hand edema, Raynaud phenomenon and sclerodactylia (anti-70 KD-U1-RNP and anti-A-U1-RNP by immunoblotting); and a lower incidence of discoid lupus and chronic renal insufficiency by lupus renal disease (ELISA). Anti-Sm antibodies are associated with Raynaud phenomenon and renal disease (CIE); cutaneous vasculitis, Raynaud phenomenon and thrombosis (anti-BB'-Sm immunoblotting); and arthritis and lower incidence of chronic renal insufficiency (ELISA). CONCLUSIONS: Anti-U1-RNP and anti-Sm antibodies detected by ELISA do not have the same clinical significance than those detected by immunoblotting or CIE. The clinical manifestations associated with such antibodies in the same SLE population vary according to the detection technique used.