Effect of Donated Premature Milk in the Prevention of Bronchopulmonary Dysplasia.

INTRODUCTION: Breastfeeding is one of the strategies that has been shown to be effective in preventing severe forms of bronchopulmonary dysplasia (BPD). When mother's own milk (MOM) is not available, pasteurized donor milk (DM) is the best alternative. However, the evidence is inconclusive on the difference in the incidence of bronchopulmonary dysplasia (BPD) between patients fed MOM and those fed with DM. As standard DM is usually mature pooled milk donated by mothers who have delivered their babies at term, the potential benefits of preterm milk may be lost. MATERIALS AND METHODS: An observational, retrospective, single-center study was conducted in the neonatology department of a high-complexity hospital. The study included newborns <32 weeks of gestational age born between January 2020 and December 2022. When supplemental milk was needed, non-pooled preterm pasteurized donor milk (PDM) matched for gestational age and moment of lactation was used in this study, classifying preterm infants in two groups: mainly MOM (>50% of the milk) or mainly PDM (>50% of the milk). Two groups were established: those who received >50% MOM and those who received >50% PDM. They were also classified according to the diagnosis of DBP: one group included no BPD or grade 1 BPD (noBPD/1), while the other included grade 2 or 3 BPD (BPD 2-3). The objectives of this study were, firstly, to evaluate the incidence of BPD 2-3 among patients who predominantly received PDM versus MOM. Secondly, to analyze differences in the type of human milk received and its nutritional components, as well as to study the growth in patients with or without BPD. RESULTS: One hundred ninety-nine patients were included in the study. A comparison of noBPD/1 versus BPD 2-3 groups between those receiving mainly MOM versus PDM showed no significant differences (19% vs. 20%, p 0.95). PDM colostrum in BPD 2-3 compared to noBPD/1 was higher in protein content (2.24 g/100 mL (SD 0.37) vs. 2.02 g/100 mL (SD 0.29) p < 0.01), although the statistical significance decreased after adjustment for gestational age and birth weight z-score (OR 3.53 (0.86-14.51)). No differences were found in the macronutrients in the mature milk of patients feeding more than 50% PDM in both study groups. Growth of BPD 2-3 showed a greater decrease in the difference in z-scores for height at birth and at discharge compared to noBPD/1 (-1.64 vs. -0.43, p 0.03). CONCLUSIONS: The use of mainly MOM or PDM demonstrates a similar incidence of noBPD/1 or BPD 2-3. Non-pooled and matched by gestational age and time of lactation preterm donor milk can probably be an alternative when mother's own milk is not available, with a similar protective effect in the prevention of severe BPD.

Genotoxicity and heating Performance of VxFe3-xO4 nanoparticles in Health applications.

The applications of magnetic nanoparticles (MNPs) as biocatalysts in different biomedical areas have been evolved very recently. One of the main challenges in this field is to design affective MNPs surfaces with catalytically active atomic centres, while producing minimal toxicological side effects on the hosting cell or tissues. MNPs of vanadium spinel ferrite (VFe2O4) are a promising material for mimicking the action of natural enzymes in degrading harmful substrates due to the presence of active V5+ centres. However, the toxicity of this material has not been yet studied in detail enough to grant biomedical safety. In this work, we have extensively measured the structural, compositional, and magnetic properties of a series of VxFe3-xO4 spinel ferrite MNPs to assess the surface composition and oxidation state of V atoms, and also performed systematic and extensive in vitro cytotoxicity and genotoxicity testing required to assess their safety in potential clinical applications. We could establish the presence of V5+ at the particle surface even in water-based colloidal samples at pH 7, as well as different amounts of V2+ and V3+ substitution at the A and B sites of the spinel structure. All samples showed large heating efficiency with Specific Loss Power values up to 400 W/g (H0 = 30 kA/m; f = 700 kHz). Samples analysed for safety in human hepatocellular carcinoma (HepG2) cell line with up to 24h of exposure showed that these MNPs did not induce major genomic abnormalities such as micronuclei, nuclear buds, or nucleoplasmic bridges (MNIs, NBUDs, and NPBs), nor did they cause DNA double-strand breaks (DSBs) or aneugenic effects-types of damage considered most harmful to cellular genetic material. The present study is an essential step towards the use of these type of nanomaterials in any biomedical or clinical application.

Prospective Assessment of Bone Metabolism Biomarkers and Survival in Metastatic Castration-resistant Prostate Cancer Patients Treated with Radium-223: The PRORADIUM Study.

BACKGROUND: Radium-223 is an active therapy option for bone metastatic castration-resistant prostate cancer (mCRPC). The lack of adequate biomarkers for patient selection and response assessment are major drawbacks for its use. OBJECTIVE: To assess the prognostic value of bone metabolism biomarkers (BMBs) in ra-223-treated mCRPC patients. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study of mCRPC patients treated with Ra-223 (PRORADIUM study: NCT02925702) was conducted. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The main objective of the study was to evaluate the association between high (≥median) baseline values in at least three bone formation (bone alkaline phosphatase [BAP] and C-terminal type-I collagen propeptide) and bone resorption (N-terminal telopeptide and pyridinoline) biomarkers, and survival. The independent prognostic value of each BMB was also assessed. The association with time to radiographic, clinical, and prostate-specific antigen (PSA) progression; time to skeletal-related events; and PSA response were secondary objectives. Multivariable (MV) Cox-regression models were evaluated. RESULTS AND LIMITATIONS: A total of 169 patients were included. Of the patients, 70.4% received Ra-223 in second/third line; 144 (85.2%) were Eastern Cooperative Oncology Group 0-1, 126 (74.6%) were in pain, and 80 (47.5%) had more than ten bone metastases. Sixty-seven (39.6%) patients had elevation in at least three BMBs. The median overall survival was 12.1 mo (95% confidence interval [CI]: 10-14.7). No association was observed with other treatment-related secondary outcome parameters. Patients with high values in three or more BMBs had significantly worse survival (9.9 vs 15.2 mo; hazard ratio [HR]: 1.8 [95% CI: 1.3-2.5]; p < 0.001) in the univariate analysis, but not independent in the MV analysis (HR: 1.33; 95% CI: 0.89-2; p = 0.181). High baseline BAP was the only biomarker associated with survival in the MV model (HR: 1.89; 95% CI: 1.28-2.79; p = 0.001). Addition of BAP to the MV clinical model increased the area under the receiver operating characteristic curve 2-yr value from 0.667 to 0.755 (p = 0.003). CONCLUSIONS: Biomarkers of bone formation, especially BAP, have prognostic value in mCRPC patients treated with radium-223. Its predictive value remains to be assessed, ideally in prospective, adequately powered, randomised clinical trials. PATIENT SUMMARY: In this study, we evaluate the role of bone metabolism biomarkers to help improve the use of radium-223 as therapy for advanced prostate cancer. We found that bone alkaline phosphatase may be a suitable tool.

[The impact of SARS-CoV-2 pandemic on patients who attend a pediatric emergency department for mental health issues]. / Impacto de la pandemia por SARS-CoV-2 en los pacientes que acuden a urgencias de pediatría por problemas de salud mental.

The lockdown during the SARS-CoV-2 pandemic and the effect of the virus on the population could be a precipitating factor for mental health disorders in the pediatric population. OBJECTIVE: To compare the reasons for consultation, diagnoses at discharge, and admission and re-consultation rates of pediatric patients attending the Emergency Department due to mental health disorders before and after the SARS-CoV-2 pandemic lockdown. PATIENTS AND METHOD: Retrospective, descriptive study. Patients under 16 years of age consulting due to mental health-related disorders during the pre- (07/01/2018-07/01/2019) and post-lockdown (07/01/2020-07/01/2021) periods were included. The frequency of mental health diagnoses, need for drug administration, hospitalization, and reconsultations were compared. RESULTS: 760 patients were included, 399 pre-lockdown and 361 postlockdown. After the lockdown, there was a 45.7% increase in the frequency of mental health-related consultations with respect to the total number of emergency consultations. Behavioral alterations were the most frequent reason for consultation in both groups (34.3% vs. 36.6%, p = 0.54). In the post-lockdown period, consultations related to self-harm attempts (16.3% vs. 24.4%, p < 0.01) and the diagnosis of depression (7.5% vs. 18.5%, p < 0.01) increased significantly. There was an increase of 58.8% in patients who were hospitalized with respect to the total number of ED patients (0.17% vs. 0.27%, p = 0.003) and in the number of re-consultations (12% vs. 17.8%, p = 0.026). No differences were observed in days of hospitalization (7 days [IQR 4-13] vs. 9 days [IQR 9-14], p0.45). CONCLUSION: In the post-lockdown period, the proportion of pediatric patients presenting to the ED with mental health disturbances increased.

Evaluación renal y multiorgánica en el paciente con encefalopatía hipóxico-isquémica / Renal and multiorgan evaluation in infants with post-asphyxial hypoxic-ischaemic encephalopathy

Resumen Introducción: La encefalopatía hipóxico-isquémica (EHI) moderada-grave secundaria a asfixia perinatal puede afectar a cualquier órgano, empeorando el pronóstico. Objetivo: Evaluar la afectación renal y multiorgánica de estos pacientes. Material y método: Se incluyó a recién nacidos > 35 semanas con EHI moderada-grave tratados con hipotermia activa entre 2010 y 2020. Se evaluó la creatinina en tres periodos: 48-72 horas de vida, entre el 3.o y 7.o día de vida y del 7.o al 28.o día de vida. Resultados: Se incluyeron 135 pacientes: 112 con EHI moderada y 23 con EHI grave. Al comparar ambos grupos, se obtuvieron diferencias significativas a las 48-72 horas y entre 3.o-7.o día de vida. No hubo diferencias al comparar el método de hipotermia. Los pacientes con EHI grave presentaron mayor afectación hemodinámica, respiratoria y hepática. Conclusiones: Neonatos con EHI grave presentan aumento de los niveles de creatinina sérica y mayor afectación multiorgánica respecto a aquellos con EHI moderada.

Abstract Background: Hypoxic-ischemic encephalopathy (HIE) secondary to perinatal asphyxia can affect any organ, worsening the prognosis. Objective: To describe renal and multiorgan involvement in moderate-severe HIE. Material and method: Newborns > 35 weeks diagnosed with moderate-severe HIE who required active hypothermia between 2010-2020 were included. To assess renal involvement, serum creatinine was measured in three different periods: at 48-72 hours, between the 3rd and the 7th day, and from the 7th to the 28th day. Results: A total of 135 patients were included, 112 (83%) with moderate and 23 (17%) with severe HIE. Significant differences were obtained when comparing median creatinine levels at 48-72 hours and between 3-7 days in both groups. There were no differences in creatinine according to the hypothermia method. Patients with severe HIE presented greater hemodynamic, respiratory, and hepatic involvement. Conclusions: Neonates with severe HIE present increased serum creatinine levels and greater multi-organ involvement than those with moderate HIE.

Coste efectividad de la estrategia de cribado de citomegalovirus en recién nacidos mayores de 34 semanas de bajo peso para la edad gestacional / Cost-effectiveness of a cytomegalovirus screening strategy in neonates born after 34 weeks small for gestational age

Introducción: El citomegalovirus (CMV) es una de las infecciones congénitas más frecuentes, con una prevalencia del 0,3-2,4%. En España, al no formar parte del cribado gestacional, se realiza screening de los recién nacidos con factores de riesgo y, en muchos centros, de los que presentan bajo peso para la edad gestacional (BPEG). Para ello se realiza, generalmente, determinación de Polymerase Chain Reaction (PCR) del virus en orina y/o ecografía transfontanelar en busca de imágenes compatibles. El objetivo del estudio es evaluar el rendimiento de la PCR de CMV en orina y ecografía transfontanelar, en recién nacidos >34 semanas asintomáticos, sin factores de riesgo, con BPEG. El objetivo secundario es evaluar el coste-efectividad. Material y métodos: Estudio observacional, descriptivo y retrospectivo, entre enero y diciembre de 2019, en un hospital de tercer nivel (IIIC). Incluye recién nacidos >34 semanas, sin factores de riesgo con BPEG, con PCR de CMV en orina y/o ecografía transfontanelar realizada. (AU)

Introduction: Infection by cytomegalovirus (CMV) is one of the most common congenital infections, with a global prevalence of 0.3%-2.4%. In Spain, CMV screening is not performed during pregnancy, but rather in neonates with risk factors, and, in many hospitals, in those born small for gestational age (SGA). Screening is usually performed by measurement of the viral load in urine by polymerase chain reaction (PCR) and/or head ultrasound in search of compatible features. The aim of the study was to assess the yield of the CMV PCR test in urine and head ultrasound examination in asymptomatic neonates born SGA after 34 weeks’ gestation. The secondary objective was to assess the cost-effectiveness of this strategy. Design and methods: We conducted an observational and retrospective study between January and December 2019 in a tertiary care hospital. It included neonates delivered after 34 weeks, SGA and without additional risk factors assessed with a CMV PCR test in urine and/or head ultrasound. (AU)

Cost-effectiveness of a cytomegalovirus screening strategy in neonates born after 34 weeks small for gestational age.

INTRODUCTION: Infection by cytomegalovirus (CMV) is one of the most common congenital infections, with a global prevalence of 0.3%-2.4%. In Spain, CMV screening is not performed during pregnancy, but rather in neonates with risk factors, and, in many hospitals, in those born small for gestational age (SGA). Screening is usually performed by measurement of the viral load in urine by polymerase chain reaction (PCR) and/or head ultrasound in search of compatible features. The aim of the study was to assess the yield of the CMV PCR test in urine and head ultrasound examination in asymptomatic neonates born SGA after 34 weeks' gestation. The secondary objective was to assess the cost-effectiveness of this strategy. DESIGN AND METHODS: We conducted an observational and retrospective study between January and December 2019 in a tertiary care hospital. It included neonates delivered after 34 weeks, SGA and without additional risk factors assessed with a CMV PCR test in urine and/or head ultrasound. RESULTS: The sample included 259 patients. It was divided in 2 groups: group 1, patients with a head circumference, weight and length below the 10th percentile (53 patients; 20.5%), and group 2, patients in whom only the weight was below the 10th percentile (206 patients; 79.5%). The incidence of late preterm birth, twin pregnancy, neonatal admission and exposure to illicit drugs during gestation was higher in group 1. A total of 186 urine PCR tests and 223 head ultrasounds were performed overall, and both tests were performed more frequently in group 1 (P=.002). There was only 1 positive CMV PCR test result in the sample (0.54%), corresponding to a patient in group 2 with no abnormal sonographic findings who remained asymptomatic throughout the follow-up. Two head ultrasound examinations yielded abnormal findings, in both cases unrelated to congenital CMV infection. We performed a cost-effectiveness analysis and determined that the cumulative cost of head ultrasound examinations and urine CMV PCR tests in our sample amounted to Є17 000 for the detection of a single asymptomatic positive case. CONCLUSION: In our population, screening for congenital CMV infection in asymptomatic late preterm and term newborns whose only risk factor is SGA does not seem to be cost effective. It would be necessary to expand the sample to other populations.

Lung recruitment in neonatal high-frequency oscillatory ventilation with volume-guarantee.

BACKGROUND AND OBJECTIVES: The optimal lung volume strategy during high-frequency oscillatory ventilation (HFOV) is reached by performing recruitment maneuvers, usually guided by the response in oxygenation. In animal models, secondary spontaneous change in oscillation pressure amplitude (ΔPhf) associated with a progressive increase in mean airway pressure during HFOV combined with volume guarantee (HFOV-VG) identifies optimal lung recruitment. The aim of this study was to describe recruitment maneuvers in HFOV-VG and analyze whether changes in ΔPhf might be an early predictor for lung recruitment in newborn infants with severe respiratory failure. DESIGN AND METHODS: The prospective observational study was done in a tertiary-level neonatology department. Changes in ΔPhf were analyzed during standardized lung recruitment after initiating early rescue HFOV-VG in preterm infants with severe respiratory failure. RESULTS: Twenty-seven patients were included, with a median gestational age of 24 weeks (interquartile range [IQR]: 23-25). Recruitment maneuvers were performed, median baseline mean airway pressure (mPaw) was 11 cm H2 O (IQR: 10-13), median critical lung opening mPaw during recruitment was 14 cm H2 O (IRQ: 12-16), and median optimal mPaw was 12 cm H2 O (IQR: 10-14, p < 0.01). Recruitment maneuvers were associated with an improvement in oxygenation (FiO2 : 65.0 vs. 45.0, p < 0.01, SpO2/FiO2 ratio: 117 vs. 217, p < 0.01). ΔPhf decreased significantly after lung recruitment (mean amplitude: 23.0 vs. 16.0, p < 0.01). CONCLUSION: In preterm infants with severe respiratory failure, the lung recruitment process can be effectively guided by ΔPhf on HFOV-VG.

A smartphone photogrammetry method for digitizing prosthetic socket interiors.

BACKGROUND AND AIM: Prosthetic CAD/CAM systems require accurate 3D limb models; however, difficulties arise when working from the person's socket since current 3D scanners have difficulties scanning socket interiors. While dedicated scanners exist, they are expensive and the cost may be prohibitive for a limited number of scans per year. A low-cost and accessible photogrammetry method for socket interior digitization is proposed, using a smartphone camera and cloud-based photogrammetry services. TECHNIQUE: 15 two-dimensional images of the socket's interior are captured using a smartphone camera. A 3D model is generated using cloud-based software. Linear measurements were comparing between sockets and the related 3D models. DISCUSSION: 3D reconstruction accuracy averaged 2.6 ± 2.0 mm and 0.086 ± 0.078 L, which was less accurate than models obtained by high quality 3D scanners. However, this method would provide a viable 3D digital socket reproduction that is accessible and low-cost, after processing in prosthetic CAD software. Clinical relevance The described method provides a low-cost and accessible means to digitize a socket interior for use in prosthetic CAD/CAM systems, employing a smartphone camera and cloud-based photogrammetry software.

Leptomeningeal carcinomatosis: prognostic value of clinical, cerebrospinal fluid, and neuroimaging features.

INTRODUCTION: Leptomeningeal carcinomatosis (LC) is a devastating complication occurring in 5% of all patients with cancer. To date there are no well-established prognostic markers in patients with LC, except for the presence of cerebrospinal fluid (CSF) blocks and the Karnofsky performance status scale (KPS). We aimed to identify clinical, neuroradiologic and CSF prognostic factors related to LC survival and to develop an easy-to-use Prognostic Scoring Scale (PSS) to identify patients who are more likely to benefit from receiving treatment. METHODS: Single-center retrospective study evaluating patients who had a diagnosis of LC during a 10-year period. Diagnosis was made by malignant cytology or imaging; suspicious cases treated as LC were also included. RESULTS: Fifty patients with LC were analyzed (58% women). Median age was 54.4 years, and KPS was 60%. The most common types of tumor were breast (35%), lung (24%), and hematologic malignancies (16%). Thirty-two percent of patients were diagnosed by imaging, 22% by cytology, and 40% by both. Median overall survival (OS) was 10 weeks (95% confidence interval 5.1-14.9). Median OS for patients who received specific treatment was 21.2 weeks vs. 6.38 weeks for patients receiving supportive care only (p<0.001). In multivariate analysis, initial KPS, initial CSF protein level (<112 mg/dL) and time from diagnosis of primary tumor to diagnosis of LC (>67 weeks) were significant and independent predictors of increased survival. CONCLUSIONS: Prognosis remains poor in LC. The predictive factors for patients with LC here identified could help to improve the selection of patients who are more likely to benefit from receiving treatment.

Fc gamma receptor polymorphisms as predictive markers of Cetuximab efficacy in epidermal growth factor receptor downstream-mutated metastatic colorectal cancer.

BACKGROUND: The immunoglobulin G1 (IgG(1)) monoclonal antibody (MoAb) Cetuximab is active in metastatic colorectal cancer (mCRC) as first or subsequent lines of therapy. Efficacy seems restricted to KRAS wild-type tumours. IgG(1) may also induce antibody dependent cell mediated citotoxicity (ADCC) by recruitment of immune effector cells. ADCC is influenced by Fc gamma receptor (FcγR) polymorphisms. We investigated the association of FcγR polymorphisms and disease control rate (DCR) in mCRC patients treated with chemotherapy plus Cetuximab. PATIENTS AND METHODS: Tumour tissues from 106 patients were screened for KRAS codon 12 and 13 mutations using a sensitive multiplex assay (DxS, Manchester, United Kingdom). NRAS (codons: 12, 13 and 61), PI3K (exon 20) and BRAF (exon 15) were analysed by direct sequencing. Fcγ RIIa and Fcγ RIIIa polymorphisms were genotyped by TaqMan assays. RESULTS: DCR was significantly higher in KRAS wild-type tumours (61% versus 39%, p = 0.049). In epidermal growth factor receptor (EGFR) downstream-mutated mCRC patients, those harbouring an FcγRIIa H/H genotype had a higher DCR than alternative genotypes (67% versus 33%, p = 0.017). By multivariate analysis, FcγRIIa-131H/H remained significantly correlated with DCR (p = 0.008). CONCLUSION: FcγR polymorphisms may play a role in the clinical efficacy of Cetuximab in EGFR downstream mutated mCRC patients. Further research into Cetuximab immune-based mechanisms in KRAS-mutated patients seems warranted.

How to provide care for patients suffering from terminal non-oncological diseases: barriers to a palliative care approach.

Despite the seemingly evident pertinence of palliative care for patients suffering from non-oncological long-term life-threatening diseases, everyday clinical practice is far from that assumption. This study aims to explore palliative care service provision for these patients in Spain. Patients, family caregivers and healthcare professionals were interviewed, individually or in a group, aiming at identifying barriers in the provision of care and strategies to overcome them. Ritchie and Spencer's framework was used for data analysis. The barriers identified were as follows: lack of clarity about prognosis, the hegemony of the curative approach, avoiding words and the desire to cheat death. Provision of palliative care services for these patients should be guided by the characteristic trajectory of each type of disease. Even if healthcare systems were capable of providing specialized palliative care services to this large group of patients, other barriers should not be overlooked. It would then seem appropriate to provide therapeutic and palliative care simultaneously, thus facilitating adaptation processes for both patients and relatives.

Establecimiento de prioridades de investigación en enfermería en España: estudio Delphi / To establish nurse research priorities in Spain: Delphi study

ObjetivoIdentificar las prioridades de investigación en cuidados de salud en España, desde la perspectiva de los profesionales de enfermería y de los usuarios de los servicios de salud.MétodoTécnica Delphi modificada desarrollada sobre un listado de 24 ítems identificados a partir del consenso previo de un grupo de trabajo. El panel de expertos participantes en la técnica Delphi modificada (2 vueltas) se compuso de cinco grupos: directores de enfermería (Atención Primaria y Hospitalaria), directores de escuelas de enfermería, presidentes de asociaciones científicas de enfermería, investigadores asistentes a los Encuentros de Investigación organizados por Investén-ISCIII, y representantes de usuarios. Se realizaron dos rondas de priorización.ResultadosTras el consenso de los partipantes, fueron consideradas como principales prioridades de investigación en cuidados: «la evaluación de la eficacia de intervenciones de enfermería», «la promoción de la salud: desarrollo de estrategias para implicar al usuario en sus cuidados», «cuidados basados en la evidencia: implantación y evaluación de resultados en la práctica clínica», y «medición de la calidad de cuidados enfermeros».ConclusionesLos resultados obtenidos a través de este estudio pueden contribuir a facilitar la toma de decisiones en materia de gestión de la investigación, ayudando a una mejor justificación y, previsiblemente, mayor financiación de los proyectos de investigación en esta área (AU)

ObjectiveTo identify nursing research priorities in Spain as suggested by nurses and service users.MethodA Modified Delphi technique was used. The first round started off with a 24-item document for which consensus had been previously achieved. Experts participating in this modified (two rounds) Delphi technique were: nursing managers (community and hospital care settings), nursing school directors, scientific nursing association representatives, nursing researchers attending the National Nursing Research Conference, and service users.ResultsMain priorities identified for nursing research were: 1) evaluating the effectiveness of nursing interventions, 2) identifying strategies for health promotion empowering service users, 3) developing evidence-based care through implementing and evaluating results, and 4) evaluating the quality of nursing care.ConclusionsResults may help research managers and administrators identify and develop nursing research promotion strategies as well as more strongly sustained funding policies and decisions(AU)

[To establish nurse research priorities in Spain: Delphi study]. / Establecimiento de prioridades de investigación en enfermería en España: estudio Delphi.

OBJECTIVE: To identify nursing research priorities in Spain as suggested by nurses and service users. METHOD: A Modified Delphi technique was used. The first round started off with a 24-item document for which consensus had been previously achieved. Experts participating in this modified (two rounds) Delphi technique were: nursing managers (community and hospital care settings), nursing school directors, scientific nursing association representatives, nursing researchers attending the National Nursing Research Conference, and service users. RESULTS: Main priorities identified for nursing research were: 1) evaluating the effectiveness of nursing interventions, 2) identifying strategies for health promotion empowering service users, 3) developing evidence-based care through implementing and evaluating results, and 4) evaluating the quality of nursing care. CONCLUSIONS: Results may help research managers and administrators identify and develop nursing research promotion strategies as well as more strongly sustained funding policies and decisions.

Lugar para el fallecimiento: preferencias de los pacientes oncológicos y sus cuidadoras / No disponible

Objetivo. Examinar las preferencias acerca del lugar de fallecimiento para 41 pacientes oncológicos en fase terminal y 18 de sus cuidadoras informales, en el área de la Bahía de Morecambe, Reino Unido. Antecedentes. El lugar de fallecimiento se ha convertido en un asunto de gran relevancia para las políticas públicas en torno al cáncer y los cuidados paliativos en el Reino Unido. Hoy en día la asunción de que 'el domicilio es el mejor lugar para morir' orienta el desarrollo de estas políticas y la provisión de servicios asociados a ellas. El intento de predicción de tal evento a partir de aproximaciones cuantitativas viene ocupando amplios espacios en la bibliografía internacional desde los años noventa. No obstante, el fenómeno de las preferencias continúa sin ser explorado desde otras perspectivas que, teniendo en cuenta la complejidad de la interacción entre los diversos elementos involucrados en tal fenómeno, aporten una visión amplia (AU)

No dispoible

La utilización de anestesia local infiltrada en la punción arterial / The utilisation of local anaesthesia infiltrated at the site of the arterial puncture

Objetivo: determinar en la literatura científica qué utilización se está haciendo de los anestésicos locales por vía subcutánea en la técnica de la punción arterial y cuál es su eficacia. Material y método: se llevó a cabo una búsqueda bibliográfica en las bases Medline, Cummultive Index to Nursing and Allied Health Literatura (CINAHL) y Cochrane Library, sin limitación alguna y utilizando las palabras clave: “arterial puncture” y “anaesthesia”. Resultados: se seleccionaron ocho artículos, pero sólo cinco eran investigaciones objeto del presente estudio. Los años de publicación de estos cinco artículos iban desde 1995 hasta 2002. La revisión puso de manifiesto que la utilización de anestésicos subcutáneos previa punción demostró ya en la década de 1980 y 1990 su eficacia en la disminución del dolor y en todas las demás experiencias subjetivas negativas asociadas a él. Conclusiones: los estudios revisados tienen una calidad científica adecuada para la implementación práctica de sus resultados y demuestran la eficacia de la infiltración previa de anestésicos locales en la reducción del dolor en la punción arterial. Existe una disociación entre las recomendaciones desde el mundo científico-teórico y la práctica clínica. Estas divergencias y su relación con los contextos clínicos habituales permiten la reflexión sobre el tema y la discusión sobre sus implicaciones para con los niveles de calidad de los cuidados enfermeros en la realización de la técnica de la punción arterial (AU)

Objective: to determine the use of subcutaneous local anaesthetics in arterial puncture and their efficacy by performing a review of the literature. Material and method: an unrestricted bibliographic search of the literature was carried out using Medline, Cumulative Index to Nursing and Allied Health (CINAHL) as well as the Cochran Library databases, with the following search terms: “arterial puncture” and “anaesthesia”. Results: eight papers were selected, of which only five were related to the subject of this study. The year of publication of these five papers stretched from 1995 to 2002. The review showed that the use of subcutaneous anaesthetics prior to the puncture had already proven to be effective back in the 80’s and 90’s in pain reduction and in other negative subjective experiences associated with pain. Conclusions: the studies reviewed are of an adequate scientific quality for the practical implementation of the results and show the effectiveness of infiltrating local anaesthetics prior to the arterial puncture for pain reduction. There is dissociation between the recommendations given from the theoretical scientific community and the real clinical practice. These divergences and their relationship with routine clinical scenarios permit one to reflect on the subject and to discuss their implications in the quality level of nursing care in respect of the technique used in arterial puncture (AU)