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Enlace permanente de la investigaciónEtiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents / Andrea Victoria Restrepo Gouzy ; Mónica Rosa Trujillo Honeysberg
Título : Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents Tipo de documento : documento electrónico Autores : Andrea Victoria Restrepo Gouzy, ; Mónica Rosa Trujillo Honeysberg, Fecha de publicación : 2022 Títulos uniformes : BMC Pediatrics Idioma : Inglés (eng) Palabras clave : Pneumonia Diagnosis Etiology Multiplex PCR Serology Induced sputum Nasopharyngeal swab Urine antigen Children Resumen : Background: Pneumonia is the leading cause of mortality in pediatric population. The etiology of pneumonia in this population is variable and changes according to age and disease severity and where the study is conducted. Our aim was to determine the etiology of community-acquired pneumonia (CAP) in children aged 1 month to 17 years admitted to 13 Colombian hospitals. Methods: Prospective cohort study. Hospitalized children with radiologically confirmed CAP and ≤ 15 days of symptoms were included and followed together with a control group. Induced sputum (IS) was submitted for stains and cultures for pyogenic bacteria and Mycobacterium tuberculosis, and multiplex PCR (mPCR) for bacteria and viruses; urinary antigens for pneumococcus and Legionella pneumophila; nasopharyngeal swabs for viruses, and paired serology for atypical bacteria and viruses. Additional cultures were taken at the discretion of primary care pediatricians. Results: Among 525 children with CAP, 71.6% had non-severe pneumonia; 24.8% severe and 3.6% very severe pneumonia, and no fatal cases. At least one microorganism was identified in 84% of children and 61% were of mixed etiology; 72% had at least one respiratory virus, 28% pyogenic bacteria and 21% atypical bacteria. Respiratory syncytial virus, Parainfluenza, Rhinovirus, Influenza, Mycoplasma pneumoniae, Adenovirus and Streptococcus pneumoniae were the most common etiologies of CAP. Respiratory syncytial virus was more frequent in children under 2 years and in severe pneumonia. Tuberculosis was diagnosed in 2.3% of children. IS was the most useful specimen to identify the etiology (33.6%), and blood cultures were positive in 3.6%. The concordance between all available diagnostic tests was low. A high percentage of healthy children were colonized by S. pneumoniae and Haemophilus influenzae, or were infected by Parainfluenza, Rhinovirus, Influenza and Adenovirus. Conclusions: Respiratory viruses are the most frequent etiology of CAP in children and adolescents, in particular in those under 5 years. This study shows the challenges in making an etiologic diagnosis of CAP in pediatric population because of the poor concordance between tests and the high percentage of multiple microorganisms in healthy children. IS is useful for CAP diagnosis in pediatric population. Mención de responsabilidad : Zulma Vanessa Rueda, Yudy Aguilar, María Angélica Maya, Lucelly López, Andrea Restrepo, Carlos Garcés, Olga Morales, Claudia Roya-Pabón, Mónica Trujillo, Catalina Arango, Ángela Rocio Copete, Cristian Vera, Margarita Rosa Giraldo, Mariana Herrera & Lázaro A. Vélez Referencia : BMC Pediatr. 2022 Mar 31;22(1):169. DOI (Digital Object Identifier) : 10.1186/s12887-022-03235-z PMID : 35361166 Derechos de uso : CC BY En línea : https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03235-z Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6029 Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents [documento electrónico] / Andrea Victoria Restrepo Gouzy, ; Mónica Rosa Trujillo Honeysberg, . - 2022.
Obra : BMC Pediatrics
Idioma : Inglés (eng)
Palabras clave : Pneumonia Diagnosis Etiology Multiplex PCR Serology Induced sputum Nasopharyngeal swab Urine antigen Children Resumen : Background: Pneumonia is the leading cause of mortality in pediatric population. The etiology of pneumonia in this population is variable and changes according to age and disease severity and where the study is conducted. Our aim was to determine the etiology of community-acquired pneumonia (CAP) in children aged 1 month to 17 years admitted to 13 Colombian hospitals. Methods: Prospective cohort study. Hospitalized children with radiologically confirmed CAP and ≤ 15 days of symptoms were included and followed together with a control group. Induced sputum (IS) was submitted for stains and cultures for pyogenic bacteria and Mycobacterium tuberculosis, and multiplex PCR (mPCR) for bacteria and viruses; urinary antigens for pneumococcus and Legionella pneumophila; nasopharyngeal swabs for viruses, and paired serology for atypical bacteria and viruses. Additional cultures were taken at the discretion of primary care pediatricians. Results: Among 525 children with CAP, 71.6% had non-severe pneumonia; 24.8% severe and 3.6% very severe pneumonia, and no fatal cases. At least one microorganism was identified in 84% of children and 61% were of mixed etiology; 72% had at least one respiratory virus, 28% pyogenic bacteria and 21% atypical bacteria. Respiratory syncytial virus, Parainfluenza, Rhinovirus, Influenza, Mycoplasma pneumoniae, Adenovirus and Streptococcus pneumoniae were the most common etiologies of CAP. Respiratory syncytial virus was more frequent in children under 2 years and in severe pneumonia. Tuberculosis was diagnosed in 2.3% of children. IS was the most useful specimen to identify the etiology (33.6%), and blood cultures were positive in 3.6%. The concordance between all available diagnostic tests was low. A high percentage of healthy children were colonized by S. pneumoniae and Haemophilus influenzae, or were infected by Parainfluenza, Rhinovirus, Influenza and Adenovirus. Conclusions: Respiratory viruses are the most frequent etiology of CAP in children and adolescents, in particular in those under 5 years. This study shows the challenges in making an etiologic diagnosis of CAP in pediatric population because of the poor concordance between tests and the high percentage of multiple microorganisms in healthy children. IS is useful for CAP diagnosis in pediatric population. Mención de responsabilidad : Zulma Vanessa Rueda, Yudy Aguilar, María Angélica Maya, Lucelly López, Andrea Restrepo, Carlos Garcés, Olga Morales, Claudia Roya-Pabón, Mónica Trujillo, Catalina Arango, Ángela Rocio Copete, Cristian Vera, Margarita Rosa Giraldo, Mariana Herrera & Lázaro A. Vélez Referencia : BMC Pediatr. 2022 Mar 31;22(1):169. DOI (Digital Object Identifier) : 10.1186/s12887-022-03235-z PMID : 35361166 Derechos de uso : CC BY En línea : https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03235-z Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6029 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001870 AC-2022-035 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-035Adobe Acrobat PDF
Título : Induced sputum as an adequate clinical specimen for the etiological diagnosis of community-acquired pneumonia (CAP) in children and adolescents Tipo de documento : documento electrónico Autores : Andrea Victoria Restrepo Gouzy, ; Mónica Rosa Trujillo Honeysberg, Fecha de publicación : 2022 Títulos uniformes : International Journal of Infectious Diseases Idioma : Inglés (eng) Palabras clave : Induced sputum adolescents children diagnosis etiology pneumonia Resumen : Objectives: This study aimed to evaluate the utility of induced sputum (IS) for the diagnosis of community-acquired pneumonia (CAP) in pediatric population. Methods: This cross-sectional study included pediatric population aged between 1 month and 17 years who were hospitalized with a diagnosis of CAP in 13 hospitals in Colombia, in whom an IS sample was obtained. Gram staining, aerobic bacterial and mycobacterial culture tests, and polymerase chain reaction (PCR) for 6 atypical bacteria and 15 respiratory viruses were performed. We evaluated the quality of IS samples. Results: IS samples were collected in 516 of 525 children included in this study. The median age was 32 months, 38.6% were younger than 2 years, and 40.9% were between 2 and 5 years. Two patients had transient hypoxemia during the procedure. The quality of the IS obtained was good in 48.4% and intermediate in 24.5%. Identification of a respiratory pathogen was achieved with an IS sample (with Gram staining, culture test, and PCR) in 372 of 516 children with CAP. Conclusion: Our study shows that IS is an adequate sample for the diagnosis of CAP in pediatric population that required hospitalization. The procedure was safe, well tolerated, and with better diagnostic yields compared with the rest of the samples obtained. Mención de responsabilidad : Zulma Vanessa Rueda, Marcela Bermúdez, Andrea Restrepo, Carlos Garcés, Olga Morales, Claudia Roya-Pabón, Luisa Fernanda Carmona, Catalina Arango, Jose Luis Albarracín, Lucelly López, Yudy Aguilar, María Angélica Maya, Mónica Trujillo, Ángela Rocio Copete, Cristian Vera, Mariana Herrera, Margarita Rosa Giraldo, Gloria Isabel Niño-Cruz, Lázaro A Vélez Referencia : Int J Infect Dis. 2022 Jan 19;116:348-354. DOI (Digital Object Identifier) : 10.1016/j.ijid.2022.01.026 PMID : 35063681 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(22)00025-X Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6010 Induced sputum as an adequate clinical specimen for the etiological diagnosis of community-acquired pneumonia (CAP) in children and adolescents [documento electrónico] / Andrea Victoria Restrepo Gouzy, ; Mónica Rosa Trujillo Honeysberg, . - 2022.
Obra : International Journal of Infectious Diseases
Idioma : Inglés (eng)
Palabras clave : Induced sputum adolescents children diagnosis etiology pneumonia Resumen : Objectives: This study aimed to evaluate the utility of induced sputum (IS) for the diagnosis of community-acquired pneumonia (CAP) in pediatric population. Methods: This cross-sectional study included pediatric population aged between 1 month and 17 years who were hospitalized with a diagnosis of CAP in 13 hospitals in Colombia, in whom an IS sample was obtained. Gram staining, aerobic bacterial and mycobacterial culture tests, and polymerase chain reaction (PCR) for 6 atypical bacteria and 15 respiratory viruses were performed. We evaluated the quality of IS samples. Results: IS samples were collected in 516 of 525 children included in this study. The median age was 32 months, 38.6% were younger than 2 years, and 40.9% were between 2 and 5 years. Two patients had transient hypoxemia during the procedure. The quality of the IS obtained was good in 48.4% and intermediate in 24.5%. Identification of a respiratory pathogen was achieved with an IS sample (with Gram staining, culture test, and PCR) in 372 of 516 children with CAP. Conclusion: Our study shows that IS is an adequate sample for the diagnosis of CAP in pediatric population that required hospitalization. The procedure was safe, well tolerated, and with better diagnostic yields compared with the rest of the samples obtained. Mención de responsabilidad : Zulma Vanessa Rueda, Marcela Bermúdez, Andrea Restrepo, Carlos Garcés, Olga Morales, Claudia Roya-Pabón, Luisa Fernanda Carmona, Catalina Arango, Jose Luis Albarracín, Lucelly López, Yudy Aguilar, María Angélica Maya, Mónica Trujillo, Ángela Rocio Copete, Cristian Vera, Mariana Herrera, Margarita Rosa Giraldo, Gloria Isabel Niño-Cruz, Lázaro A Vélez Referencia : Int J Infect Dis. 2022 Jan 19;116:348-354. DOI (Digital Object Identifier) : 10.1016/j.ijid.2022.01.026 PMID : 35063681 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(22)00025-X Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6010 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001845 AC-2022-016 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-016Adobe Acrobat PDF
Título : Real-world evidence of epidemiology and clinical outcomes in multiple myeloma, findings from the registry of hemato-oncologic malignancies in Colombia, observational study Tipo de documento : documento electrónico Autores : Kenny Mauricio Gálvez Cárdenas, Fecha de publicación : 2022 Títulos uniformes : Clinical Lymphoma, Myeloma & Leukemia Idioma : Inglés (eng) Palabras clave : Multiple myeloma Colombia Diagnosis Therapy autologous transplantation disease registry real-world Resumen : Multiple Myeloma (MM) is a plasma cell derived clonal disorder that represents around 1% of all newly diagnosed neoplasms. Limited data regarding MM treatment in Latin America is available, and access to novel agents for a substantial portion of the population is limited by their high costs. 1 . In this multicenter cohort study, data on 890 Colombian MM patients are reported with a median follow-up of 18 months (IQR: 7-42 months). Patients were classified by age group (≤ or > 65 years). Median age at diagnosis was 67 years (IQR: 59-75 years) and 47.1% of patients were women. 709 patients (79.6%) received Bortezomib-based schemes as part of the first line, with Cyclophosphamide-Bortezomib-Dexamethasone (CyBorD) being the most frequently used (301 patients; 33.8%). Only two hundred and fifty-two patients (28.3%) were consolidated with Autologous Stem Cell Transplantation (ASCT) in first-line therapy. ASCT consolidation and age were the main independent factors influencing outcomes; in the non-ASCT cohort, 5-year overall survival was 48.7% (CI 41.8-55.2) compared to 80.7% (CI 73-86.4) in ASCT patients. This data depicts the reality of MM in Colombia, which likely reflects other Latin American countries, where access barriers to diagnosis and treatment are echoed in advanced stage diagnosis and a low rate of transplants. These seem to negatively impact survival despite the availability of most novel drugs approved in most of the world for this disease. Thus, emphasizing the paradox that prevails in most of the region: availability without equitable access. Mención de responsabilidad : Virginia Abello, William Armando Mantilla, Henry Idrobo, Claudia Lucia Sossa, Luis Antonio Salazar, Angela Pena, Juan Manuel Herrera, Paola Guerrero, Daniel Espinosa, Guillermo Enrique Quintero-Vega, Isabel Munevar, Kenny Galvez, Alicia Henao, Rigoberto Gómez, Jose Domingo Saavedra, Lina María Gaviria, Mónica Osuna y María Victoria Mateos Referencia : Clin Lymphoma Myeloma Leuk. 2021 Dec 13;S2152-2650(21)02478-2. DOI (Digital Object Identifier) : 10.1016/j.clml.2021.12.009 PMID : 35042679 En línea : https://linkinghub.elsevier.com/retrieve/pii/S2152265021024782 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5841 Real-world evidence of epidemiology and clinical outcomes in multiple myeloma, findings from the registry of hemato-oncologic malignancies in Colombia, observational study [documento electrónico] / Kenny Mauricio Gálvez Cárdenas, . - 2022.
Obra : Clinical Lymphoma, Myeloma & Leukemia
Idioma : Inglés (eng)
Palabras clave : Multiple myeloma Colombia Diagnosis Therapy autologous transplantation disease registry real-world Resumen : Multiple Myeloma (MM) is a plasma cell derived clonal disorder that represents around 1% of all newly diagnosed neoplasms. Limited data regarding MM treatment in Latin America is available, and access to novel agents for a substantial portion of the population is limited by their high costs. 1 . In this multicenter cohort study, data on 890 Colombian MM patients are reported with a median follow-up of 18 months (IQR: 7-42 months). Patients were classified by age group (≤ or > 65 years). Median age at diagnosis was 67 years (IQR: 59-75 years) and 47.1% of patients were women. 709 patients (79.6%) received Bortezomib-based schemes as part of the first line, with Cyclophosphamide-Bortezomib-Dexamethasone (CyBorD) being the most frequently used (301 patients; 33.8%). Only two hundred and fifty-two patients (28.3%) were consolidated with Autologous Stem Cell Transplantation (ASCT) in first-line therapy. ASCT consolidation and age were the main independent factors influencing outcomes; in the non-ASCT cohort, 5-year overall survival was 48.7% (CI 41.8-55.2) compared to 80.7% (CI 73-86.4) in ASCT patients. This data depicts the reality of MM in Colombia, which likely reflects other Latin American countries, where access barriers to diagnosis and treatment are echoed in advanced stage diagnosis and a low rate of transplants. These seem to negatively impact survival despite the availability of most novel drugs approved in most of the world for this disease. Thus, emphasizing the paradox that prevails in most of the region: availability without equitable access. Mención de responsabilidad : Virginia Abello, William Armando Mantilla, Henry Idrobo, Claudia Lucia Sossa, Luis Antonio Salazar, Angela Pena, Juan Manuel Herrera, Paola Guerrero, Daniel Espinosa, Guillermo Enrique Quintero-Vega, Isabel Munevar, Kenny Galvez, Alicia Henao, Rigoberto Gómez, Jose Domingo Saavedra, Lina María Gaviria, Mónica Osuna y María Victoria Mateos Referencia : Clin Lymphoma Myeloma Leuk. 2021 Dec 13;S2152-2650(21)02478-2. DOI (Digital Object Identifier) : 10.1016/j.clml.2021.12.009 PMID : 35042679 En línea : https://linkinghub.elsevier.com/retrieve/pii/S2152265021024782 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5841 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001776 AC-2021-091 Archivo digital Producción Científica Artículos científicos Disponible
Título : Psychogenic nonepileptic seizures in Latin America: A survey describing current practices Tipo de documento : documento electrónico Autores : Lady Diana Ladino Malagón, Fecha de publicación : 2021 Títulos uniformes : Epilepsy & Behavior Idioma : Inglés (eng) Palabras clave : Diagnosis Barriers Health services Nonepileptic seizures Psychotherapy Treatment Resumen : Objective: Psychogenic nonepileptic seizures (PNES) are one of the most common differential diagnoses of epilepsy. This study provides an overview of diagnostic and treatment services for patients with PNES across Latin America. Methods: In 2017–2018, clinicians practicing in Latin America with responsibilities for patients with PNES were contacted to respond to a survey regarding the management of this disorder developed by the International League Against Epilepsy (ILAE) PNES Task Force. Results: Three hundred and sixty responses from 17 Latin American countries were analyzed. Most respondents were neurologists (81%) under 40 years of age (61%). Fifty-seven percent of professionals stated that they personally diagnose PNES, but only 33% stated that they provide follow-up, and only 20% that they recommend treatment. Many participants (54%) characterized themselves as either unfamiliar with the diagnosis or inexperienced in arranging treatment. Most respondents reported having access to brain magnetic resonance imaging (MRI; 88%) and routine electroencephalogram (EEG; 71%), 64% have the access to video-EEG longer than 8 h, and 54% of professionals performed video-EEG to confirm PNES diagnoses. Although cognitive–behavioral therapy was recognized as the treatment of choice (by 82% of respondents), there was little access to it (60%). In contrast, a high proportion of respondents reported using antidepressant (67%), antiseizure (57%), and antipsychotic medications (54%) as treatments for PNES. Significance: This study reveals several deficiencies in the diagnosis and treatment of patients with PNES in Latin America. The barriers are reinforced by lack of knowledge among the specialists and poor healthcare system support. There is inadequate access to prolonged video-EEG and psychotherapy. An inappropriate use of antiseizure medicines seems commonplace, and there are low follow-up rates by neurologists after the diagnosis. Multidisciplinary guidelines are required to improve the approach of patients with PNES. Mención de responsabilidad : Lady Diana Ladino, Vanessa Benjumea-Cuartas, Yamile Calle-López, Juan Pablo Orozco-Hernández, Diana Marcela Castrillón-Velilla, Reydmar López-González, Anilu Daza-Restrepo, Mario Alberto Genel Castillo, Markus Reuber, Alyssa Denton, José F Tellez-Zenteno Referencia : Epilepsy Behav. 2021 Jan;114(Pt A):107150. DOI (Digital Object Identifier) : 10.1016/j.yebeh.2020.107150 PMID : 32507294 En línea : https://linkinghub.elsevier.com/retrieve/pii/S1525505020303292 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5117 Psychogenic nonepileptic seizures in Latin America: A survey describing current practices [documento electrónico] / Lady Diana Ladino Malagón, . - 2021.
Obra : Epilepsy & Behavior
Idioma : Inglés (eng)
Palabras clave : Diagnosis Barriers Health services Nonepileptic seizures Psychotherapy Treatment Resumen : Objective: Psychogenic nonepileptic seizures (PNES) are one of the most common differential diagnoses of epilepsy. This study provides an overview of diagnostic and treatment services for patients with PNES across Latin America. Methods: In 2017–2018, clinicians practicing in Latin America with responsibilities for patients with PNES were contacted to respond to a survey regarding the management of this disorder developed by the International League Against Epilepsy (ILAE) PNES Task Force. Results: Three hundred and sixty responses from 17 Latin American countries were analyzed. Most respondents were neurologists (81%) under 40 years of age (61%). Fifty-seven percent of professionals stated that they personally diagnose PNES, but only 33% stated that they provide follow-up, and only 20% that they recommend treatment. Many participants (54%) characterized themselves as either unfamiliar with the diagnosis or inexperienced in arranging treatment. Most respondents reported having access to brain magnetic resonance imaging (MRI; 88%) and routine electroencephalogram (EEG; 71%), 64% have the access to video-EEG longer than 8 h, and 54% of professionals performed video-EEG to confirm PNES diagnoses. Although cognitive–behavioral therapy was recognized as the treatment of choice (by 82% of respondents), there was little access to it (60%). In contrast, a high proportion of respondents reported using antidepressant (67%), antiseizure (57%), and antipsychotic medications (54%) as treatments for PNES. Significance: This study reveals several deficiencies in the diagnosis and treatment of patients with PNES in Latin America. The barriers are reinforced by lack of knowledge among the specialists and poor healthcare system support. There is inadequate access to prolonged video-EEG and psychotherapy. An inappropriate use of antiseizure medicines seems commonplace, and there are low follow-up rates by neurologists after the diagnosis. Multidisciplinary guidelines are required to improve the approach of patients with PNES. Mención de responsabilidad : Lady Diana Ladino, Vanessa Benjumea-Cuartas, Yamile Calle-López, Juan Pablo Orozco-Hernández, Diana Marcela Castrillón-Velilla, Reydmar López-González, Anilu Daza-Restrepo, Mario Alberto Genel Castillo, Markus Reuber, Alyssa Denton, José F Tellez-Zenteno Referencia : Epilepsy Behav. 2021 Jan;114(Pt A):107150. DOI (Digital Object Identifier) : 10.1016/j.yebeh.2020.107150 PMID : 32507294 En línea : https://linkinghub.elsevier.com/retrieve/pii/S1525505020303292 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5117 Reserva
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Título : Use of suggestive seizure manipulation methods in the investigation of patients with possible psychogenic nonepileptic seizures—An international ILAE survey Tipo de documento : documento electrónico Autores : Lady Diana Ladino Malagón, Fecha de publicación : 2021 Títulos uniformes : Epilepsia Open Idioma : Inglés (eng) Palabras clave : Psychogenic nonepileptic seizures (PNES) dissociative seizures provocation methods activation procedures electroencephalography suggestion diagnosis Resumen : Video-encephalographic (vEEG) seizure recordings make essential contributions to the differentiation of epilepsy and psychogenic nonepileptic seizures (PNES). The yield of vEEG examinations can be increased through suggestive seizure manipulation (SSM) (ie, activation/provocation/cessation procedures), but its use has raised ethical concerns. In preparation for guidelines on the investigation of patients with PNES, the ILAE PNES Task Force carried out an international survey to investigate practices of and opinions about SSM. An online questionnaire was developed by the ILAE PNES Task Force. Questions were asked at clinical unit or individual respondent level. All ILAE chapters were encouraged to send questionnaires to their members. The survey was open from July 1, 2019, to August 31, 2019. A total of 487 clinicians from 411 units across 94 countries responded. Some form of SSM was used in 296/411 units (72.0%). Over 90% reported the use of verbal suggestion, over 80% the use of activation procedures also capable of eliciting epileptic activity (hyperventilation or photic stimulation). Only 26.3% of units used techniques specifically intended to provoke PNES (eg, saline injection). Fewer than 10% of units had established protocols for SSM, only 20% of units required written patient consent, in 12.2% of units patients received explicitly false information to provoke seizures. Clinicians using SSM tended to perceive no ethical problems, whereas those not using SSM were likely to have ethical concerns about these methods. We conclude that the use of invasive nocebo techniques intended to provoke PNES in diagnostic settings has declined, but SSM is commonly combined with activation procedures also capable of eliciting epileptic activity. While research suggests that openness about the use of PNES-specific nocebo techniques does not reduce diagnostic yield, very few units have suggestion protocols or seek patient consent. This could be addressed through establishing consensus guidance for the practice of SSM. Mención de responsabilidad : Adrien Gras, Alistair Wardrope, Edouard Hirsch, Ali A Asadi Pooya, Rod Duncan, David Gigineishvili, Coraline Hingray, Kousuke Kanemoto, Lady Ladino, William Curt LaFrance, Aileen McGonigal, Chrisma Pretorius, Paola Valenti Hirsch, Pierre Vidailhet, Dong Zhou, Markus Reuber Referencia : Epilepsia Open. 2021 Sep;6(3):472-482. DOI (Digital Object Identifier) : 10.1002/epi4.12521 PMID : 34288577 Derechos de uso : CC BY En línea : https://onlinelibrary.wiley.com/doi/full/10.1002/epi4.12521 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5811 Use of suggestive seizure manipulation methods in the investigation of patients with possible psychogenic nonepileptic seizures—An international ILAE survey [documento electrónico] / Lady Diana Ladino Malagón, . - 2021.
Obra : Epilepsia Open
Idioma : Inglés (eng)
Palabras clave : Psychogenic nonepileptic seizures (PNES) dissociative seizures provocation methods activation procedures electroencephalography suggestion diagnosis Resumen : Video-encephalographic (vEEG) seizure recordings make essential contributions to the differentiation of epilepsy and psychogenic nonepileptic seizures (PNES). The yield of vEEG examinations can be increased through suggestive seizure manipulation (SSM) (ie, activation/provocation/cessation procedures), but its use has raised ethical concerns. In preparation for guidelines on the investigation of patients with PNES, the ILAE PNES Task Force carried out an international survey to investigate practices of and opinions about SSM. An online questionnaire was developed by the ILAE PNES Task Force. Questions were asked at clinical unit or individual respondent level. All ILAE chapters were encouraged to send questionnaires to their members. The survey was open from July 1, 2019, to August 31, 2019. A total of 487 clinicians from 411 units across 94 countries responded. Some form of SSM was used in 296/411 units (72.0%). Over 90% reported the use of verbal suggestion, over 80% the use of activation procedures also capable of eliciting epileptic activity (hyperventilation or photic stimulation). Only 26.3% of units used techniques specifically intended to provoke PNES (eg, saline injection). Fewer than 10% of units had established protocols for SSM, only 20% of units required written patient consent, in 12.2% of units patients received explicitly false information to provoke seizures. Clinicians using SSM tended to perceive no ethical problems, whereas those not using SSM were likely to have ethical concerns about these methods. We conclude that the use of invasive nocebo techniques intended to provoke PNES in diagnostic settings has declined, but SSM is commonly combined with activation procedures also capable of eliciting epileptic activity. While research suggests that openness about the use of PNES-specific nocebo techniques does not reduce diagnostic yield, very few units have suggestion protocols or seek patient consent. This could be addressed through establishing consensus guidance for the practice of SSM. Mención de responsabilidad : Adrien Gras, Alistair Wardrope, Edouard Hirsch, Ali A Asadi Pooya, Rod Duncan, David Gigineishvili, Coraline Hingray, Kousuke Kanemoto, Lady Ladino, William Curt LaFrance, Aileen McGonigal, Chrisma Pretorius, Paola Valenti Hirsch, Pierre Vidailhet, Dong Zhou, Markus Reuber Referencia : Epilepsia Open. 2021 Sep;6(3):472-482. DOI (Digital Object Identifier) : 10.1002/epi4.12521 PMID : 34288577 Derechos de uso : CC BY En línea : https://onlinelibrary.wiley.com/doi/full/10.1002/epi4.12521 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5811 Reserva
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2021-061Adobe Acrobat PDF
