Fundamento. La prevalencia de dolor crónico en España es del 17%. Es conveniente recopilar evidencia científica acerca de las terapias no farmacológicas que sean efectivas para el tratamiento del dolor crónico. El objetivo fue analizar las percepciones sobre las terapias no farmacológicas de los pacientes con dolor crónico no oncológico. Método. Estudio mixto, descriptivo y fenomenológico. Se realizó un taller de control del dolor mediante terapias no farmacológicas de cuatro sesiones (una a la semana), de cuatro horas de duración cada una, en el que participaron 19 pacientes. Se analizó la escritura reflexiva sobre las vivencias personales de cada uno de los participantes. Se utilizó el software Atlas Ti 8 para analizar los datos cualitativos. Resultados. Dieciséis participantes habían probado alguna terapia alternativa y catorce valoraban sus beneficios. Las expectativas de los participantes se clasificaron en tres grupos de similar tamaño: alivio del dolor físico, manejo del dolor emocional, y herramientas aplicables en su vida cotidiana. Todos los participantes estuvieron satisfechos con el taller. Los beneficios personales percibidos fueron mejor manejo del dolor y del sueño; disminución de la fatiga; reducción del consumo de medicamentos; mejora de la actitud ante la vida, del estado emocional, mayor energía positiva y motivación, y mejor afrontamiento. Conclusiones. Los participantes afirmaron que el taller les había ayudado a disminuir el dolor y el consumo de analgésicos, así como otros síntomas asociados a la enfermedad crónica, mejorando por tanto su salud percibida. Además, manifestaron gran satisfacción con la organización y las docentes.

Introduction: The use of smartphones to provide specialist ophthalmology services is becoming a more commonly used method to support patients with eye pathologies. During the COVID-19 pandemic, demand for telehealth services such as tele-ophthalmology, is increasing rapidly. Methods: In 2019, the agreement between diagnostic tests was investigated by comparing the diagnostic performance for eye posterior pole pathologies of the images obtained by a smartphone coupled to a medical device known as open retinoscope (OR), handled by a nurse and subsequently assessed by an ophthalmologist versus the images obtained by an ophthalmologist using a slit lamp associated to a 76 diopter indirect ophthalmic lens (Volk Super FieldVR ) (SL-IOL) at the outpatient department of a hospital. The OR used in this study worked with a 28 diopter indirect lens. Results: An examination of 151 dilated eyes (79 adult patients, mean age of 66.7 years, 59.5% women) was conducted. Sensitivity was 98.9%, specificity was 89.8%, the positive predictive value was 93.8% and the negative predictive value was 98.2%. The kappa index between both tests was 0.90 (95% CI: 0.83-0.97) in basic diagnosis, 0.81 (95% CI: 0.74-0.89) in syndromic diagnosis (13 categories) and 0.70 (95% CI: 0.62-0.77) in advanced diagnosis (23 categories). Discussion: Images obtained by a nurse using a smartphone coupled to the OR and subsequently assessed by an ophthalmologist showed a high diagnostic performance for eye posterior pole pathologies, which could pave the way for remote ophthalmology systems for this patient group.

Background: In spite of technical advances, hip fracture causes high mortality in the elderly. We wanted to know early surgery influence to mortality during admission, one year and after five years, as well as readmissions at one month and one year. We also wanted to know how dependence and Health-Related Quality of Life (HRQOL) evolved in the twelve months of follow-up and what factors were associated with poor patient evolution. Methods: A prospective observational study was made in patients over 65 years of age treated for osteoporotic hip fracture in a level III hospital between 2010- 2012, with consecutive sampling. We evaluated functionality (Barthel) and quality of life (EuroQol-5D) basal (before fracture), within 30 days, within six and twelve months; readmissions within the 30 days and within one year; and mortality during admission; within one and five years. We used the statistical program SPSS Version 25.0 for the statistical analysis. Results: We followed 327 patients of 82.9 (SD: 6.9) years of means, 258 (78.9%) were women. Fifty-four (45.9%) were treated within 24 hours and 237 (72.5%) within 48 hours. They returned 14 (4.3%) within the 30 days and 44 (13.5%) within the one year. There were 8 deaths during admission (2.4%) and 61 (19.2%) in the first year and 185 (54,6%) within five years. The pre-fracture quality of life was 0.43 median (0.24-0.74), at the month 0.15 (0.07-0.28), at six months 0.26 (0, 13-0.59) and at twelve 0.24 (0.15-0.58). The previous functionality was 85.0 (55.0-100) at the month 35.0 (20.0-60.0) and 60.0 (25.0-85.0) at six and twelve months. There were significant differences between all visits except between six and twelve months. Conclusions: The patients get worse significantly at the month of surgery and recover in the six months, remaining at twelve, without reaching the baseline value. The results in mortality and readmissions per year are worse for men and older. Early surgery does not reduce mortality, but re-admissions to the year.