Mapeo cruzado de los factores relacionados y de riesgo de NANDA-I con la Clasificación Internacional de Enfermedades / Cross-mapping of Related and Risk Factors of NANDA-I with those of the International Classification of Diseases

Introducción: Enfermería desarrolla su actividad en un contexto multidisciplinar donde se mezclan la esfera autónoma y la de otros profesionales, y es de primordial la competencia diagnóstica. NANDA-International es la clasificación enfermera más utilizada; mientras que la Clasificación Internacional de Enfermedades es la de referencia para los problemas médicos. En ocasiones, los factores relacionados/riesgo de NANDA-International coinciden con diagnósticos médicos. Objetivo: Realizar mapeo cruzado entre NANDA-International y la Clasificación Internacional de Enfermedades. Métodos: Estudio observacional con distribución de frecuencias mediante mapeo cruzado identificando sinónimos o cuasi-sinónimos en ambas clasificaciones. Resultados: Se determinaron n = 1715 factores relacionados/riesgo, n = 1193 clasificados en una ocasión y n = 522 duplicados. Los factores genuinos y específicos fueron n = 1593 (52,16 por ciento); n = 1460 (47,84 por ciento) estaban también en la clasificación médica. Conclusiones: Algunos Dominios y clases NANDA-International muestran factores genuinos y específicos de la disciplina enfermera; otros están, además, en la clasificación médica, cuya resolución no es competencia autónoma enfermera. De esta manera, NANDA-International puede llegar a convertirse en un instrumento extenso y poco útil, con etiologías poco específicas. Se deben mejorar y potenciar contenidos relativos a metaparadigmas enfermeros para hacerse visible con entidad propia en los sistemas de salud(AU)

Introduction: Nursing develops its activity in a multidisciplinary setting where the autonomous sphere and that of other professionals are mixed, while diagnostic competence is paramount. NANDA-International is the most widely used nurse classification, while the International Classification of Diseases is the reference for medical problems. Occasionally, the related factors/risk of NANDA-International coincide with medical diagnoses. Objective: To carry out cross-mapping between NANDA-International and the International Classification of Diseases. Methods: Observational study with frequency distribution by cross-mapping and identifying synonyms or quasi-synonyms in both classifications. Results: We determined 1715 related factors/risk; 1193 were classified on one occasion and 522 were duplicated. The genuine and specific factors were 1593 (52.16 percent); 1460 (47.84 percent) were also in the medical classification. Conclusions: Some NANDA-International domains and classes show genuine and specific factors in the nursing discipline, while others are also in the medical classification, whose resolution is not autonomously a nursing competence. In this way, NANDA-International can become an extensive and unhelpful tool, with little specific etiologies. Content related to nursing metaparadigms must be improved and enhanced to become visible with their own entity in the health systems(AU)

Resultados de un programa multidisciplinario para el control del hábito tabáquico / Results of a multidisciplinary program to quit smoking

Background: Therapies to quit smoking are based on counseling, psychological therapy (PT), nicotine replacement therapy, bupropion or varenidine. Aim: To report the results of a multidisciplinary program to quit smoking Material and Methods: Patients agedl8years or more, motivated to quit smoking were admitted in a program based in counseling and PT, with or without pharmacological therapy. They were assessed by telephone during one year offollow up. Patients with unstable psychiatric diseases were excluded. Results were considered as "successful" when patients maintained abstinence during the year offollow up. A logistic regression analysis was done to identify factors associated with treatment success. Results: Between 2005 and 2011, 198 patients aged 45 ± 11 years (56% males), who smoked 31.5 ± 20.6 packages/year, were treated. Ofthese, 155 (78%) were treated with varenidine, 26 (13%) with bupropion and 17 (9%>) did not receive pharmacological therapy. One hundred sixty eightpatients completed the year offollow up. In 82 (49%>), treatment was successful and was negatively associated with a history of depression (odds ratio = 4 (95% confidence intervals 1.23-38.33). The main side effeets associated to varenidine and bupropion were nausea in 37 and 23%o, sleep disorders in 20 and 19%o and headache in 12 and 0%>, respectively Conclusions: A multidisciplinary program to quit smoking achieved a 49%> of abstinence during a year offollow up.

Carcinoma hepatocelular variedad fibrolamelar metastásico en menores de 20 años: Reporte de 2 casos tratados con intención curativa y revisión de la literatura / Fibrolamellar liver carcinoma: Report of two cases

Fibrolamellar hepatocellular carcinoma (FLC) is a rare histologic variant of hepatocellular carcinoma that appears most commonly in teenagers and young adults. The diagnosis is often made incidentally and surgical resection is the only curative treatment. Here we report two cases of incidental FLC involving a 19 year-old male, initially diagnosed with screening abdominal ultrasound, and a 14 year-old female that presented with abdominal pain. Diagnostic workup consisted of abdominal PET/CT and MRI Imaging studies and tissue diagnosis was confirmed with percutaneous liver biopsy. Both patients were treated with radical liver resection/tumor excision. However, tumor recurrence was observed in both during short-term follow-up. The male patient was treated successfully with surgical treatment however the female patient succumbed top regression of disease.

Temas de sexualidad que preguntan adolescentes a través de la prensa / Subjects of sexuality that adolescents through the press ask

Estudio descriptivo de 870 preguntas de adolescentes, sobre sexualidad y reproducción recibidas en el suplemento dominical Vida Afectiva y Sexual, del Diario la Cuarta de Santiago y reagrupadas en 10 grandes temas. Fueron 57,8 por ciento mujeres y 42,2 por ciento varones, sin diferencias por edad. Para el análisis se aplico el test de Chi cuadrado y análisis multinominal. Los temas más consultados: Relaciones Sexuales, Anatomía relacionada al sexo, Homosexualidad e ITS, Embarazo en Adolescentes y Masturbación. Los/las adolescentes menores preguntan más sobre Masturbación y Desarrollo Puberal y los/las adolescentes mayores en Anticoncepción. No hubo tendencia por edad en los temas de Relaciones Sexuales, Embarazo, Relaciones Afectivas y Familiares y Homosexualidad e ITS. Los varones preguntan significativamente más sobre Masturbación, Anatomía relacionada al Sexo y Homosexualidad e ITS. Las mujeres preguntan más de Relaciones sexuales, Embarazo y Relaciones Afectivas y Familiares. No hubo diferencias por Regiones. De los Subtemas de Relaciones Sexuales los más consultados fueron: Inicio Sexual relacionado con el Desarrollo Puberal, Dispareunia y Anorgasmia. Hubo tendencia a mayor edad por la inquietud acerca de Dispareunia y Anorgasmia. En conclusión se confirma la urgencia de desarrollar programas de educación sexual en el Sector Público y capacitar a los docentes, padres y apoderados para satisfacer las necesidades de las/los adolescentes. La educación debe ser impartida por igual a hombres y mujeres, considerando algunos temas en complejidad creciente en relación a la edad.

Surgical treatment of multirresistant lung tuberculosis

The medical treatment of tuberculosis with chemotherapy has a rate of failure near 2 por cento, associated with drugs resistance of first, second and third line regimens. In such cases, lung resection plays a significant role as an adjuvant method in treating it by resection of localized lesions, so is possible to decrease the pool of bacilli and then improve the drug response. In a retrospective review of 139 patients with multirresistant pulmonary tuberculosis between 1980 and 1990 32 cases were operated on. There were 17 men and 15 women all of them infected by mycobacterium tuberculosis resistant to rifampin and isoniazid. The resections performed were: pneumonectomy in 14 cases, lobectomy in 13 and segmentectomy in 5. The operative mortality was 6.2 por cento. The postoperative follow-up to 18 months showed a negative sputum culture in 90 por cento of the survivors and the others relapsed after the initial conversion. The results of this study show a high rate of conversion in patients with multiresistant tuberculosis treated with resective lung surgery

Transplante pulmonar y cardiopulmonar / Pulmonary and cardiopulmonary transplantation

Los transplantes pulmonares y cardiopulmonares han logrado grandes avances en esta década, luego del advenimiento de la ciclosporina, inmunosupresor selectivo de los linfocitos T, que ha cambiado radicalmente el pronóstico de los transplantes de órganos. Los trabajos publicados por las Universidades de Stanford y Pittsburg y por grupos europeos, han demostrado la ulilidad y el éxito alcanzado con los transplantes cardiopulmonares en block; en patologías como: enfisema pulmonar, hipertensión pulmonar primaria o secundaria, fibrosis quística, sarcoidosis, linfangioleiomiomatosis, defectos del septo interventricular o interatrial y granuloma eosinófilo, generalmente realizados en pacientes con cor pulmonar y en capacidad funcional IV. Las publicaciones recientes del grupo de Toronto abren nuevas expectativas para el transplante pulmonar aislado, que debe restringirse a pacientes portadores de fibrosis pulmonar sin cor pulmonale. Los resultados logrados por éstos grupos son excelentes, con relativamente baja mortalidad precoz y excelente sobrevida y calidad de vida, pues todos los pacientes transplantados llegan a capacidad funcional I