Effects of a Clinical Simulation-Based Training Program for Nursing Students to Address Social Isolation and Loneliness in the Elderly: A Quasi-Experimental Study.

INTRODUCTION: The population of older adults is rapidly increasing worldwide, presenting both prospects and complexities for society and healthcare professionals to maximize the functional capacity of this age group. Social isolation and loneliness significantly affect this population. The objective was to determine the effectiveness, satisfaction, and perceptions of the simulation-based education practices of a training program for nursing students, which was created to palliate the social isolation and loneliness of older adults. METHOD: A quasi-experimental study was conducted with nursing students who participated in an online training program using teleservice based on high-fidelity clinical simulation. The program included asynchronous theoretical training and synchronous practical training using an online platform. Five scenarios were designed using simulated phone calls to address the social isolation and loneliness of older adults. RESULTS: Twenty-five nursing students participated in the program, and they had a mean age of 27.44, with 76% of them being women. After the training program, the participants showed statistically significant improvements (p < 0.05) with respect to their knowledge and attitudes towards older adults, and the program was adapted to the best educational practices in simulations. CONCLUSIONS: Simulation-based online training efficiently improved the knowledge and attitudes of nursing students towards older adults, improving their ability to address social isolation and loneliness. The high satisfaction and adhesion to the best educational practices underline the usefulness of high-fidelity online simulations, especially in situations in which face-to-face training is not feasible, and accessibility and equilibrium could be guaranteed between work and personal life.

Relación entre sobrepeso y obesidad con la progresión de la enfermedad renal crónica en pacientes del Centro Médico Naval en México / Association between overweight and obesity with the progression of chronic kidney disease in patients of Centro Médico Naval in Mexico

Introducción: La progresión de la enfermedad renal crónica podría estar asociada directa o indirectamente al sobrepeso y la obesidad; sin embargo, hasta el momento no hay evidencias suficientes para constatar esta relación. Objetivo: Determinar si el sobrepeso y obesidad son factores que contribuyen a una progresión más acelerada de la enfermedad renal crónica en una muestra de pacientes del Centro Médico Naval.Material y Método: A través de un estudio cuantitativo y observacional, de tipo comparativo, longitudinal y retrospectivo, se determinaron los cambios en el normopeso, sobrepeso y obesidad en 44 pacientes. La progresión de la enfermedad renal crónica se determinó con base en la tasa de filtración glomerular y niveles de albuminuria que presentaron estos pacientes. Los datos se recabaron con un instrumento de registro de diseño propio, durante un seguimiento de 3 años que se llevó a cabo de enero de 2019 a diciembre de 2021. Resultados: Los resultados muestran una tendencia al aumento en la progresión de la enfermedad renal crónica.Conclusiones: A pesar de que se encontró una tendencia al aumento, no se pudo probar una asociación estadísticamente significativa entre la obesidad y el sobrepeso con la progresión de esta enfermedad.(AU)

Introduction: The progression of chronic kidney disease could be directly or indirectly associated with overweight and obesity; however, until now there is not enough evidence to verify this association. Objective: To determine if overweight and obesity are factors that contribute to a more accelerated progression of chronic kidney disease in a sample of patients from the Centro Médico Naval. Material and Method: A comparative, longitudinal, and retrospective study was carried out. Changes in normal weight, overweight, and obesity were determined based on glomerular filtration rate and albuminuria levels presented by such patients. Data collection was performed using a custom-designed instrument during a 3-year follow-up from January 2019 to December 2021. Results: The results show an increasing trend in the progression of chronic kidney disease. Conclusions: Despite the increasing trend, a statistically significant association between overweight and obesity and the progression of this disease could not be proven.(AU)

Extensive traumatic anterior chest wall injury including type I manubriosternal dislocation.

Manubriosternal joint dislocation (MSD) is a rare traumatic injury, usually preceded by a high energy trauma. We report a case of a 40-year-old female who was involved in a motor vehicle accident and presented to a tertiary trauma centre. She suffered from severe chest wall injuries, including significantly displaced manubriosternal dislocation with lung herniation, bilateral rib fractures and hemopneumothoraxes. She underwent a chest wall reconstruction with open reduction and internal fixation with sternal and costal plates with good functional outcome. In this case report we discuss the management of these rare and unstable type I manubriosternal dislocation with associated rib fractures.

Perforated Meckel's diverticulitis secondary to a corn kernel obstruction of lumen in an elderly patient.

Meckel's diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract. The most frequent complications are bleeding, intestinal obstruction, intussusception and neoplasm. Perforation because of diverticulitis is very rare and usually associated to foreign bodies. We report a case of an elderly man who presented with right iliac fossa pain, raised inflammatory markers and a computer tomography (CT) scan suggestive of Meckel's diverticulitis. He underwent a laparoscopic converted to open small bowel resection and primary anastomosis for perforated MD, which revealed a corn kernel at its base in the absence of ectopic gastric or pancreatic tissue. Symptomatic and perforated MD secondary to a phytobezoar is extremely rare in elderly patients, hence the importance of clinical suspicion in patients with abdominal pain, independent from their age, to avoid delay in diagnosis, which can lead to increased morbidity and mortality in this demographic.

Experiencia de manejo de pacientes críticos con COVID-19 en Hospital Barros Luco: análisis descriptivo en un hospital público de alta complejidad / Experience of managing critical patients with COVID-19 at Hospital Barros Luco: descriptive analysis in a high complexity public Hospital

RELEVANCIA: La pandemia por COVID-19 (Coronavirus Disease-2019) se origina en diciembre de 2019. En Chile, a la fecha se han reportado 13.037 fallecidos con un enorme costo y esfuerzo asistencial, siendo limitada aun la evidencia en Chile acerca de esta enfermedad. OBJETIVOS: Describir el perfil clínico y ventilatorio de los pacientes con COVID-19 que requirieron manejo en la Unidad de Cuidados Intensivos en un Hospital Terciario de la Región Metropolitana. MÉTODOS: Estudio descriptivo, observacional y retrospectivo. Se extrajeron los datos de 64 pacientes ingresados entre el 24 de Marzo y el 15 de Mayo de 2020 en la UCI del Hospital Ramón Barros Luco Trudeau en el Sector Sur de la Región Metropolitana. Los resultados primarios en el estudio fueron Mortalidad en UCI, Mortalidad Intrahospitalaria y Mortalidad a 28 días. RESULTADOS: La mortalidad en UCI fue del 20%, existiendo una asociación entre Hipertensión Arterial y Enfermedad más Grave. La obesidad se asoció con mayores días UCI. En cuanto al soporte ventilatorio, 75% de los pacientes requirió apoyo con VMI al ingreso. Existe un perfil de mejor Compliance pulmonar y bajo potencial de reclutamiento durante la primera semana. Sin embargo, entre el 7mo. y 14vo día de enfermedad existe una rápida progresión hacia menor compliance pulmonar en cierto grupo de pacientes. CONCLUSIONES: Los casos más graves de COVID-19 se dan en pacientes de avanzada edad, hipertensos y obesos, con un aumento significativo en mortalidad cuando asociaron enfermedad renal crónica sobre todo en hemodiálisis. La progresión hacia deterioros severos de la elastancia pulmonar probablemente constituyen el signo ominoso de la enfermedad.

¿Cómo ayuda la aplicación del proceso enfermero a las mujeres con diagnóstico ansiedad? / How can the application of the nursing process help to women with anxiety nursing diagnosis?

Objetivo: Evaluar las intervenciones grupales de enfermería en mujeres con diagnóstico enfermero ansiedad mediante el resultado NOC autocontrol de la ansiedad. Material y método: Estudio pre-experimental del tipo pretest-postest de un solo grupo realizado en un Centro de Salud Mental de la Región de Murcia a un grupo de 12 mujeres en edad adulta que presentan el diagnóstico enfermero ansiedad. Se realizó a cada paciente la valoración de enfermería por Patrones Funcionales de Salud (PFS) antes y después de la asistencia a las 8 sesiones de intervenciones enfermeras grupales. Al comenzar y al finalizar el grupo, se cumplimentó el criterio de resultado NOC autocontrol de la ansiedad. Las intervenciones enfermeras fueron a) disminución de la ansiedad (5820), terapia de relajación simple (6040), educación sanitaria (5510), enseñanza grupo (5604) y grupo de apoyo (5430). Se tomó como variable independiente las intervenciones enfermeras y como variable dependiente las puntuaciones del resultado NOC, empleándose como instrumento de evaluación. Resultados: El análisis del resultado NOC autocontrol de la ansiedad nos muestra diferencias significativas. Antes de las intervenciones, la media presenta el valor 22.5 y tras las mismas de 37.8 con una desviación típica de 3.22 y 7.11 respectivamente. La mediana antes y después de las intervenciones corresponde con los valores 21 y 37.5. El parámetro del test de los rangos de Wilcoxon corresponde con un valor de Z igual a -2.98 con una p igual a 0.003. Conclusiones: El estado, conducta y percepciones de las pacientes del grupo medido con el resultado autocontrol de la ansiedad, mejora tras recibir las intervenciones enfermeras. La puntuación global de los indicadores empleados en este resultado ha sido apropiada como medida de los efectos de las intervenciones (AU)

Purpose: To evaluate nursing group interventions in women with anxiety nursing diagnosis by self NOC result of anxiety. Methodology: Pre-experimental pretest-posttest study composed by a single group of twelve women in a Mental Health Center of the Region of Murcia. The participants were a group of women in adulthood presenting the nursing diagnosis anxiety. Each patient received 8 group nursing interventions. Before and after the group intervention, a nursing outcome criteria is filled for each patient. The following nursing interventions were used: Anxiety reduction (5820), simple relaxation therapy (6040), health education (5510), group education (5604) and support group (5430). The independent variable was nursing interventions and the dependent variable was NOC punctuations, being used as an assessment tool. Results: The analysis of the NOC result anxiety self-control shows significant differences. Before the intervention, the mean was 22.5 and 37.8 after it with standard deviations of 3.22 and 7.11 for each one. The median was 21 before interventions and 37.5 after them. The Wilcoxon test shows a Z value of -2.98 with p 0.003. Conclusion: The state, behaviour and perception of patients improve with nursing interventions received. The global punctuation of used clinical indicators is a good tool to measure nursing intervention effects (AU)

[Tuberculous arthritis of the temporomandibular joint caused by Mycobacterium bovis. A diagnostic conundrum]. / Artritis temporomandibular por Mycobacterium bovis. Un problema diagnóstico.

Infrequent variants of extrapulmonary tuberculosis pose a challenging public health problem because of the delay in their diagnosis and treatment. Joint involvement is usually encountered in major joints (hip, elbow, knee and ankle). Tuberculous involvement of the temporomandibular joint is extremely uncommon but must be considered in patients with pain, inflammation or joint stiffness not resolved with conventional treatment.

Artritis temporomandibular por Mycobacterium bovis. Un problema diagnóstico / Tuberculous arthritis of the temporomandibular joint caused by Mycobacterium bovis. A diagnostic conundrum

Las variantes infrecuentes de tuberculosis extrapulmonar son un reto de salud pública por abocar a un retraso diagnóstico-terapéutico. Las formas articulares se localizan en las grandes articulaciones (cadera, rodilla, codo, tobillo). La afectación temporomandibular es extremadamente infrecuente, pero debe ser considerada ante todo dolor, inflamación o rigidez articular que no se resuelva con tratamientos convencionales y, por tanto, ser investigada (AU)

Infrequent variants of extrapulmonary tuberculosis pose a challenging public health problem because of the delay in their diagnosis and treatment. Joint involvement is usually encountered in major joints (hip, elbow, knee and ankle). Tuberculous involvement of the temporomandibular joint is extremely uncommon but must be considered in patients with pain, inflammation or joint stiffness not resolved with conventional treatment (AU)