Even with optimized medical care for the management of pain, many pediatric patients with sickle cell disease (SCD) report persistently high pain and have corresponding functional impairments. The Comfort Ability Program (CAP), a daylong pediatric pain management intervention, was adapted via a 4-phase knowledge translation process into a video-based intervention to specifically and flexibly address sickle cell pain (SCP). CAP for SCP introduces psychological and biobehavioral pain management techniques to adolescents with SCD and their parents or caregivers. A primary goal of our structured development process and feasibility testing was to ensure ease of access and delivery by addressing identified barriers to care that have historically limited widespread dissemination of evidence-based programs for patients with SCD. Method: The development of CAP for SCP was completed in 4 phases: (1) convening an expert panel to review the literature, discuss logistical and cultural barriers to care, and adapt the curriculum of a 1-day pain management workshop to a video-based format that could specifically meet the needs of a SCD population; (2) conducting a pilot testing of content with patients and parents followed by semistructured focus group discussion; (3) generating and producing the interactive video, audio materials, and corresponding workbook for intervention delivery; and (4) testing

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Con el objetivo de describir los resultados del uso de fibrinolíticos (alteplase endovenoso o rtPA) en pacientes con ECV isquemico, se realizó un estudio descriptivo, observacional y prospectivo en 23 pacientes que fueron diagnosticados con ECV isquemico, además se describieron los principales factores de riesgo y los porcentajes de recuperación usando las escalas de Rankin y Barthel modificados. Se encontró que el factor de riesgo más frecuente fue la hipertensión arterial. El tiempo total desde que se presentaron los síntomas hasta la administración del tratamiento tuvo una media de 168,78 minutos, la escala de NISSH aplicada a los pacientes tuvo un promedio de 2,1 puntos a las 24 horas, 1,26 puntos a los 7 días y 0,5 puntos a los 3 meses, 20 de los pacientes trombolisados obtuvieron un puntaje de 0-2 en la escala de Rankin de y de >95 en la escala de Barthel. Finalmente concluimos que el uso de fibrinoliticos en pacientes con ECV isquemico produce mejoría clínica y menor discapacidad evaluados por las escalas de Rankin y Barthel modificados.

Heart failure (HF) is a clinical syndrome characterized by inadequate tissue oxygen supply. In spite of the best current approach to heart diseases, population aging in individuals with heart disease has resulted in increased incidence of HF.

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