ABSTRACT
Siguiendo las nuevas líneas de acción en materia de seguridad propuestas por Osakidetza en relación con la disminución de infecciones del tracto urinario asociadas a catéteres, y continuando con el interés creciente por una práctica clínica basada en la evidencia, se ha llevado a cabo una actualización del protocolo del sondaje vesical. Tras una exhaustiva búsqueda bibliográfica se han determinado puntos clave en el procedimiento del sondaje vesical y se están estudiando estrategias para difundir este protocolo. En la práctica se verán reflejadas en acciones dirigidas a evitar sondajes innecesarios, retirada precoz de las sondas, técnicas asépticas en la inserción, correcto mantenimiento, seguimiento de ITU relacionadas con el sondaje. Todo esto es un proceso sin concluir que nos va a llevar a adaptarnos a unas recomendaciones e intervenciones enfermeras basadas en la mejor evidencia
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Subject(s)
Humans , Cystostomy/nursing , Urinary Catheterization/nursing , Urinary Tract Infections/prevention & control , Catheter-Related Infections/prevention & control , Evidence-Based Nursing/methods , Nursing AssessmentABSTRACT
La incidencia del cáncer vesical en España se aproxima a 9.000 nuevos casos por año. Es el cuarto tumor en el varón y aproximadamenteel 15-25% tendrá afectación muscular o incluso linfática. La cistectomía radical es el tratamiento por excelencia en el carcinoma vesical infiltrante.En estos pacientes la preparación general para la cirugía debe comprender tanto aspectos psicológicos como físicos. Dentro de lapreparación psíquica se incluye la información amplia del procedimiento a realizar y posibles resultados, especialmente cuando la intervenciónpuede ser desfigurante al ser necesaria la colocación de una urostomía, ya que el paciente tolera mejor los inconvenientes cuando sele han explicado previamente los beneficios. Nuestro objetivo es la elaboración e implantación de un documento de referencia para estandarizarlas actuaciones de los profesionales en el momento de dar información sanitaria prequirúrgica al paciente urostomizado. (AU)
The incidence of bladder cancer in Spain approaches to 9,000 new cases per year. It is the 4th tumor among male and approximately 15-25%-25 will have muscular or even lymphatic affectation. Radical cystectomy is the treatment par excellence in the vesical carcinoma infiltranting.In these patients the general preparation for surgery must include psychological aspects as much as physical. In psychic preparationis included the wide information of the procedure to carry out and possible results, especially when the intervention can be disfiguringbecause the placing of an urostomy is necessary, since patients tolerate the inconveniences better when the benefits have been explainedto them previously. Our goal is the elaboration and introduction of a reference document to standardize the action of professionals atthe moment of giving the urostomyzed patient presurgical sanitary information (AU)
Subject(s)
Humans , Urinary Diversion/psychology , Cystectomy/psychology , Urinary Bladder Neoplasms/surgery , Consumer Health Information , Truth Disclosure , Patient RightsABSTRACT
Glioblastoma multiforme is one of the most devastating cancers and presents unique challenges to therapy because of its aggressive behavior. Cancer-initiating or progenitor cells have been described to be the only cell population with tumorigenic capacity in glioblastoma. Therefore, effective therapeutic strategies targeting these cells or the early precursors may be beneficial. We have established different cultures of glioblastoma-initiating cells (GICs) derived from surgical specimens and found that, after induction of differentiation, the NFκB transcriptional pathway was activated, as determined by analyzing key proteins such as p65 and IκB and the upregulation of a number of target genes. We also showed that blockade of nuclear factor (NF)κB signaling in differentiating GICs by different genetic strategies or treatment with small-molecule inhibitors, promoted replication arrest and senescence. This effect was partly mediated by reduced levels of the NFκB target gene cyclin D1, because its downregulation by RNA interference reproduced a similar phenotype. Furthermore, these results were confirmed in a xenograft model. Intravenous treatment of immunodeficient mice bearing human GIC-derived tumors with a novel small-molecule inhibitor of the NFκB pathway induced senescence of tumor cells but no ultrastructural alterations of the brain parenchyma were detected. These findings reveal that activation of NFκB may keep differentiating GICs from acquiring a mature postmitotic phenotype, thus allowing cell proliferation, and support the rationale for therapeutic strategies aimed to promote premature senescence of differentiating GICs by blocking key factors within the NFκB pathway.
