Diagnósticos Enfermeros prevalentes en pacientes mayores con úlceras por presión: estudio transversal / Prevalent nursing diagnoses in elderly with pressure ulcers: cross-sectional study / Diagnósticos Enfermeiros prevalentes em pacientes idosos com úlceras por pressão: estudo transversal

Resumen Objetivo Determinar la prevalencia de los diagnósticos enfermeros en pacientes adultos mayores hospitalizados con úlceras por presión e identificar los diagnósticos enfermeros reales, potenciales, de salud y síndrome por patrón funcional de salud. Material y métodos Estudio Transversal, descriptivo conformado por una muestra de pacientes adultos mayores hospitalizados en diferentes servicios de un Hospital de Acapulco, Guerrero, México. Para su evaluación, se diseñó un instrumento de acuerdo con los patrones funcionales de Marjory Gordon. Se utilizó la plataforma de mejores prácticas de enfermería E-cuidados® para el análisis. Resultados El presente estudio identificó 36 diagnósticos relevantes, de los cuales 23 (63.9 %) fueron diagnósticos centrados en el problema, 10 (27.8 %) diagnósticos de riesgo y 3 (8.3 %) de promoción a la salud. Los patrones funcionales más afectados son; Actividad-Ejercicio, Nutricional-Metabólico y Valores-Creencias. Conclusiones El presente estudio ayuda a enfatizar la importancia de adoptar estrategias preventivas y de atención integral, así como la mejora de la planificación de la atención para evitar el deterioro de las condiciones en los pacientes adultos mayores.

Abstract Objective To determine the prevalence of diverse nursing diagnostics in hospitalized older patients with pressure ulcers, identifying the real, potential, and health-related ones, as well as syndrome by health functional pattern. Methods and material This is a transversal and descriptive study with a sample of older patients in different services in a hospital of Acapulco, Guerrero, Mexico. An assessment instrument was designed following the Functional Patterns of Marjory Gordon. The E-cuidados® best nursing practices platform was used for the analysis. Results 36 relevant diagnostics were identified: 23 (63.9 %) were problem-centered; 10 (27.8 %) were risk related; and 3 (8.3 %) were health promoting. The most affected functional patterns were: Activity-Exercise; Nutrition-Metabolism; and Values-Beliefs. Conclusions This study supports the need to highlight the importance of adopting preventive and integral attention strategies, as well as improving the attention planning process in order to avoid the deterioration of health conditions of older patients.

Resumo Objetivo Determinar a prevalência dos diagnósticos enfermeiros em pacientes idosos hospitalizados com úlceras por pressão e identificar os diagnósticos enfermeiros reais, potenciais, de saúde e síndrome por padrão funcional de saúde. Material e métodos Estudo Transversal, descritivo conformado por uma amostra de pacientes idosos hospitalizados em diferentes serviços de um Hospital de Acapulco, Guerrero, México. Para sua avaliação, desenhou-se um instrumento conforme com os padrões funcionais de Marjory Gordon. Utilizou-se a plataforma de melhores práticas de enfermagem E-cuidados® para a análise. Resultados O presente estudo identificou 36 diagnósticos relevantes, dos quais 23 (63.9 %) foram diagnósticos centrados no problema, 10 (27.8 %) diagnósticos de risco e 3 (8.3 %) de promoção à saúde. Os padrões funcionais mais afetados são; Atividade-Exercício, Nutricional-Metabólico e Valores-Crenças. Conclusões O presente estudo ajuda a enfatizar a importância de adotar estratégias preventivas e de atenção integral, assim como a melhora da planificação da atenção para evitar a deterioração das condições nos pacientes idosos.

Determinación del grado de infestación e infección de vectores de la enfermedad de Chagas en la comunidad de Huayhuasi (Mecapaca) / Determination of the degree of infestation and infection of vectors of Chagas disease in the community of Huayhuasi (Mecapaca)

Los trabajos realizados de trampeo y captura de triatominos (que son los insectos vectores de la enfermedad de Chagas) en zonas silvestres de los alrededores de la localidad de Huayhuasi, municipio de Mecapaca en el departamento de La Paz. Se colocaron 50 trampas en lugares estratégicos escogidos de acuerdo a las características del área de estudio. De las 50 trampas, en 9 trampas se lograron atrapar a los triatominos, lo que representa el 4.5% de infestación de la zona de estudio. Se capturaron a 13 insectos (7 ninfas de diferentes estadíos y 6 adultos). Las características morfológicas de los insectos fueron las típicas del Triatoma infestans. En el examen en fresco de las deyecciones de los 6 especímenes adultos capturados, en 4 de ellos se detectó presencia del parásito Trypanosoma cruzi, lo cual demuestra un 67% de infección, porcentaje bastante significativo en consideración a la cercanía de estos lugares infestados a las zonas urbanas del municipio de Mecapaca. Los parásitos que los especímenes portaban, fueron aislados y cultivados en medio de cultivo LIT (Liver Infusion Tryptose) suplementado con 10% de suero bovino fetal e incubados en estufa a 26°C. El análisis del ADN extraído de los parásitos, ha revelado la DTU (Discrete Typing Unit) correspondiente al linaje TcI.

Trapping and capture of triatomines (which are the insect's vectors of Chagas' disease) were carried out in wild areas around the town of Huayhuasi, municipality of Mecapaca, in the department of La Paz. 50 traps were placed in strategic places chosen according to the characteristics already established. Of the 50 traps, nine traps managed to trap the triatomines, representing 4.5% of infestation in the study area. 13 insects (7 nymphs of different stages and 6 adults) were captured. The morphological characteristics of the insects were typical of Triatoma infestans. In the fresh examination of the excrement of the six captured adult specimens, in 4 of them the presence of the parasite Trypanosoma cruzi was detected, which shows a 67% infection, a very significant percentage considering the proximity of these infested places to the Urban areas of the municipality of Mecapaca. The parasites that the specimens carried were isolated and cultured in LIT (Liver Infusion Triptose) medium supplemented with 10% fetal bovine serum and incubated in an oven at 26 °C. Analysis of the DNA extracted from the parasites has revealed the DTU corresponding to the Tc I lineage.

Acoso laboral entre personal de enfermería / Mobbing among nursing staff / Assédio laboral entre trabalhadores de enfermagem

Objetivo Analizar los trabajos, sobre el acoso entre profesionales de enfermería: prevalencia, factores de riesgo y consecuencias. Método: Revisión sistemática de las publicaciones científicas sobre el acoso entre el personal de enfermería, en la última década. Se consultaron diferentes bases de datos nacionales (Dialnet, ISOC Ciencias Sociales y Humanidades, IME Biomedicina) e internacionales (CINHAL, Medline, PsycINFO, PubMed Central), así como directorios de revistas con acceso abierto (DOAJ). En todos los casos, se limitó la búsqueda al intervalo 2005-2014. Los criterios establecidos fueron: 1) estudios que analicen el acoso laboral entre el personal de enfermería; 2) cualquier diseño metodológico; 3) que aporten datos empíricos sobre el estado de la cuestión; 4) con acceso al texto completo; y 5) escritos en inglés, español o portugués. De un total de 96 publicaciones, fueron seleccionadas 18. Resultados: Los resultados muestran una prevalencia de acoso, entre el personal de enfermería, en torno al 17-20%. Se identifican factores de riesgo como: edad inferior a 30 años, corta trayectoria profesional, y trabajar en determinadas unidades o turnos. Las consecuencias para la víctima fueron: problemas psicológicos, bajo rendimiento y deterioro de relaciones sociales. Conclusiones: Destacar la escasa producción científica sobre el tema y la necesidad de desarrollar instrumentos, que permitan una evaluación ajustada de las conductas de intimidación y acoso, entre profesionales de la enfermería.

Objective To analyze studies on mobbing among nursing professionals, risk factors, and consequences. Method: This is a systematic review of scientific works on mobbing among nursing staff published during the last decade (2005-2014). National (Dialnet, ISOC Ciencias Sociales y Humanidades, IME Biomedicina) and international (CINHAL, Medline, PsycINFO, PubMed Central) databases, as well as directories of open access journals were consulted. Established criteria were: 1) studies analyzing mobbing among nursing staff; 2) any methodological design; 3) offering empirical data on the topic; 4) access to the full text; 5) written in English, Spanish, or Portuguese. From a total of 96 studies identified, 18 were finally selected. Results: The findings show a prevalence of mobbing among nursing staff of around 17-20%. Risk factors such as age younger than 30 years old, brief professional trajectory, and being working in specific units or shifts were identified. Among the consequences, psychological problems, low productivity, and social relations deteriorations were identified. Conclusions: It is important to highlight the scanty scientific production on the topic, and also the necessity to develop instruments which allow an adequate assessment of harassment conducts among nursing professionals.

Objetivo Analisar os trabalhos sobre o assédio entre profissionais de enfermagem: prevalência, fatores de risco e consequências. Método: Revisão sistemática das publicações científicas sobre o assédio entre os trabalhadores de enfermagem na última década. Consultaram-se diferentes bases de dados nacionais (Dialnet ISOC Ciencias Sociales y Humanidades, IME Biomedicina) e internacionais (CINHAL, Medline, PsycINFO, PubMed Central), assim como diretórios de revistas com livre acesso (DOAJ). Em todos os casos, limitou-se à busca do intervalo de 2005-2014. Os critérios estabelecidos foram: 1) estudos que analisem o assédio laboral entre os trabalhadores de enfermagem, 2) qualquer desenho metodológico, 3) que aportem dados empíricos sobre o estado da questão, 4) com acesso ao texto completo, e, 5) escritos em inglês, espanhol e português. De um total de 96 publicações, foram escolhidas 18. Resultados: Os resultados mostram uma prevalência de assédio, entre os trabalhadores de enfermagem, em volta a 17-20%. Identificam-se fatores de risco como: idade inferior a 30 anos, curta trajetória professional, e trabalhar em determinadas unidades ou turnos. As consequências para a vítima foram: problemas psicológicos, baixo rendimento e deterioro de relações sociais. Conclusões: Destacar a escassa produção científica de enfermagem sobre o tema, e a necessidade de desenvolver instrumentos, que permitam uma avaliação ajustada das condutas de intimidação e assédio, entre profissionais da enfermagem.

GEICO (Spanish Group for Investigation on Ovarian Cancer) treatment guidelines in ovarian cancer 2012.

In 2006, under the auspices of The Spanish Research Group for Ovarian Cancer (Spanish initials GEICO), the first "Treatment Guidelines in Ovarian Cancer" were developed and then published in Clinical and Translational Oncology by Poveda Velasco et al. (Clin Transl Oncol 9(5):308-316, 2007). Almost 6 years have elapsed and over this time, we have seen some important developments in the treatment of ovarian cancer. Significant changes were also introduced after the GCIG-sponsored 4th Consensus Conference on Ovarian Cancer by Stuart et al. (Int J Gynecol Cancer 21:750-755, 2011). So we decided to update the treatment guidelines in ovarian cancer and, with this objective, a group of investigators of the GEICO group met in February 2012. This study summarizes the presentations, discussions and evidence that were reviewed during the meeting and during further discussions of the manuscript.

Characterization of native and oxidized human low-density lipoproteins by the Z-scan technique.

The nonlinear optical response of human normal and oxidized by Cu2+ low-density lipoproteins particles (LDL), were investigated by the Z-scan technique as a function of temperature and concentration of LDL particles. The Z-scan signals increase linearly with concentration of normal LDL particles, following the usual Beer-Lambert law in a broad range of concentrations. The oxidized LDL particles do not show nonlinear optical response. On the other hand, normal LDL increases its nonlinear optical response as a function of temperature. These behaviors can be attributed to an absorbing element that is modified by the oxidative process. Contrarily, changes in the physical state of the cores and conformation of the ApoB100 protein due to an increase in temperature seems to enhance their nonlinear optical properties. This tendency is not due to aggregation of particles. The main contribution to the nonlinear optical response of normal LDL particles comes from the phospholipid fraction of the particles.

Randomised efficacy and safety study of two 3-day artesunate rectal capsule/mefloquine regimens versus artesunate alone for uncomplicated malaria in Ecuadorian children.

The combination of artesunate and mefloquine is one of the most effective treatments against multidrug-resistant falciparum malaria. Experience in children is however limited. The objective of this study was to compare the efficacy and safety of two artesunate/mefloquine combinations with artesunate monotherapy in Ecuadorian children. A total of 150 children with an age between 2 and 12 years, confirmed to have uncomplicated falciparum malaria, were randomly selected and divided in three treatment groups of 50 patients each. Group 1 received 50 mg rectal capsules alone (40 mg/kg total dose) administered over 6 days. Group 2 received 50 mg rectal capsules (30 mg/kg total dose) for 3 days combined with mefloquine (20 mg/kg total dose) on day 1. Group 3 was treated with 50 mg rectal capsules (30 mg/kg total dose) for 3 days, combined with mefloquine on days 1 and 3 (15-17 mg/kg total dose). Patients were continuously followed up and controlled by clinical and laboratory examinations for 7 days as well as on days 14, 21 and 28. An additional parasite examination was performed at 2 months following therapy. Clearance of parasitaemia was comparable between treatment groups. These were 9.2, 9.2 and 8.3 h for Groups 1, 2 and 3, respectively. Cure rates at day 28 were 76, 96 and 94% and after 2 months 60, 88 and 80%, respectively. There were no adverse events (AEs) reported during the study. Vital signs and laboratory examinations revealed no changes of clinical relevance. It can be concluded that the combination of artesunate rectal capsules with mefloquine is effective and safe. Starting concomitant administration already on day 1 is well tolerated. This combination significantly reduces the incidence of recrudescence compared to artesunate monotherapy. Comparing the two tested artesunate/mefloquine regimens, a total mefloquine dose of 20 mg/kg seems to be more effective compared to a total dose of 15-17 mg/kg. Further studies seem to be warranted.

[Methods of pedicle hemostasis in laparoscopically-assisted vaginal hysterectomy (VAVH). Evaluation of results]. / Métodos para la hemostasia de pedículos en histerectomía vaginal asistida laparoscópicamente (LAVH). Evaluación de resultados.

The objective was to evaluate whether use of different techniques of hemostasia have effect on laparoscopically assisted vaginal hysterectomy (LAVH) morbidity. Was performed a review of 53 LAVH cases, parameters analyzed were type of hemostasia method and surgical complications. There were five patients with transoperative bleeding and two with incidental bladder lesion, that were managed successfully without complications. There were no significant differences between types of hemostasia with respect to transoperative bleeding. There were no mayor surgical complications in the studied patients. As conclusion LAVH allows patients a expedite recovery with low postoperative complications. All the methods used in this work to perform hemostasia in LAVH are safe and effective for patients with habitual hysterectomy indications.

[Immune response in the surgical patient: effect of anesthesia and blood transfusion]. / Respuesta inmune en el paciente quirúrgico: influencia de la anestesia y la transfusión sanguínea.

Anesthesiology has progressed spectacularly over the last two decades, largely parallel to developments in basic and clinically applied sciences such as immunology. The anesthesiologist's involvement now extends to all matters involved in perioperative care. Surgery, anesthetic procedures themselves, and other associated techniques such as blood transfusion all alter the patient's immune response and all fall within the range of procedures monitored by the anesthesiologist. The repercussions on the patient are important, given that alterations suppose increased risk of postoperative infection and increased recurrence of neoplastic disease. The present article reviews available knowledge on how and to what extent the patient's immune status is affected in the perioperative period. Generally, surgery and anesthesia induce immune system depression. It is possible to demonstrate a decrease in the number and activity of circulating immune cells and alterations of various types in interleukins and in protein synthesis during acute phase response. Research in this field is complex given that the individual effect of each factor involved is difficult to measure and experimental or clinical designs usually yield only biased views. Replacement of lost red blood cells is another factor leading to immunological changes. New anesthetic techniques, the optimization of methods already in use, and the development of modern, less immunodepressant drugs and of alternatives to homologous blood transfusion are all solutions that have been proposed. This is an exciting field of study in which today, perhaps more than ever, the anesthesiologist has a critical role to play.

[Vaginal hysterectomy assisted by laparoscopy. Critical and comparative study if vaginal and abdominal hysterectomy at the A.B.C. Hospital of Mexico]. / Histerectomía vaginal asistida por laparoscopia. Estudio crítico y comparativo con histerectomía vaginal y abdominal en el Hospital A.B.C. de la Ciudad de México.

The laparoscopically assisted vaginal hysterectomy offers the possibility to convert abdominal to vaginal approach give to the patient the benefits of ti. The analysis of the first 20 cases in our institution is done and are compared with abdominal and vaginal approaches in some parameters including costs, indications and hospitalization days. The laparoscopically assisted vaginal hysterectomy offers to the patient the benefits of the vaginal approach with hospital stay similar and cost and operative time higher than those for either vaginal and abdominal hysterectomy. The exact role of the laparoscopically assisted vaginal hysterectomy on daily practice still is pending.

[New perspectives for an old problem: premature labor]. / Nuevas perspectivas para un problema antiguo: el trabajo de parto pretérmino.

Preterm birth has been and continues to be one of the most serious problems in Obstetrics. It is the most common cause of neonatal death, and morbidity in surviving infants. The presence of bacterial vaginosis, and other genital infections is associated with increased risk of preterm labor. Cytokines promote the release of prostaglandin, and have been implicated as cause of uterina activity. Recently, new methods of detection as transvaginal ultrasonography, and measures of cervical fetal fibronectin have been acclaimed as useful to detect the problem. Atosiban, cytokines, glyceril trinitrate, and many others agents have been proposed as treatments and are under investigation. Such drugs, will allow an effective management of preterm labor with lower side effects. Antenatal TRH administration cannot be recommended for widespread clinical use. However, the antenatal administration of corticosteroids to fetuses at risk of preterm delivery include not only a reduction in the risk of respiratory distress syndrome but also a significative reduction in intraventricular hemorrhage mortality.

Immunoglobulin allotypes in Ecuadorian Cayapa Indians.

Indigenous Indian groups comprise approximately 20% of Ecuador's population, the third largest percentage in all of Central or South America, yet immunogenetic data on these groups are lacking in the literature. In the course of population migration studies, sera collected from 65 Ecuadorians living in the northern province of Esmeraldas were typed for six GM and two KM markers. The study population consisted of 47 Cayapa Indians and 18 blacks of African origin, descendants of slaves imported into the area during the seventeenth century. The Cayapa demonstrated three GM phenotypes, two of which are common to other South American Indian tribes. The frequency of KM1 positive Cayapa Indians (63%) is similar to other South American Indian tribes, but is significantly greater than the Huaorani of eastern Ecuador (2%), the only other Ecuadorian Indian group for whom limited immunoglobulin allotype data are available (chi 2 = 35.8, P < 0.0001).

Comprobación y análisis de la adaptación del inventario multifásico de la personalidad (forma corta) con lenguaje simplificado / Verification and analysis of adaptation of the minnesota multiphasic personality inventory (short version) with simplified lenguage

Se simplificó el lenguaje del Inventario Multifásico de la Personalidad (MMPI), versión original traducido al español, para hacerlo comprensible a la población de escolaridad limitada de nuestro país, utilizando como muestra 280 sujetos normales de uno y otro sexos, de edad entre 18 y 60 años, con escolaridad máxima de sexto grado de primaria. Para la validación de esta muestra se incluyó una segunda población de 201 sujetos masculinos normales de escolaridad equivalente. En esta validación, se utilizó el diseño de una sola muestra Método Test-Retest. Para el Test se utilizó la versión original de MMPI y para el Retest la versión del lenguaje simplificado de la misma prueba. La significancia de los cambios de respuesta de cada uno de los 383 reactivos de la prueba entre el Test y el Retest se analizó mediante la prueba de Mc Nemar. La correlación Test-Retest de cada una de las 13 escalas clínicas del MMPI se analizó mediante el coeficiente de correlación Producto-Momento de Pearson. En nueve de las 13 escalas de la prueba que contenían el mayor número de reactivos modificados, se encontraron diferencias significativas. De los 383 reactivos, 171 fueron modificados o simplificados y, de éstos, 58 presentaron cambios significativos en al respuesta entre Test-Retest, lo que permite suponer que la simplificación del lenguaje aumenta la sensibilidad del instrumento. De las 113 respuestas que no tuvieron cambios significativos, 32 corresponden a reactivos que reafirman la consistencia interna de la prueba. Los 81 restantes corresponden a reactivos extremos, los cuales hacen alusión a experiencias de vida que manifiestan una patología o son culturalmente inaceptables en sujetos normales, independientemente del lenguaje que se utilice. Los 29 reactivos que no fueron modificados y presentaron cambios significativos corresponden a preguntas sensibles a los cambios ambientales o de las circunstancias del sujeto. Concluimos que la simplificación del lenguaje no afectó la consistencia de la prueba y mejoró la confiabilidad al aumentar la comprensión de las preguntas

[Hemoglobin Setif (alpha 94 (G1) Asp----Tyr) in a Spanish family]. / Hemoglobina Setif (alpha 94 (G1) Asp----Tyr) en una familia española.

A family was studied who carried a slow mobility haemoglobin on cellulose acetate electrophoresis at pH 8.6. The structural analysis of the anomalous globin chain showed substitution of residual aspartic acid in position 94 of the alpha chain by tyrosine (Hb Setif). This mutation induces low oxygen affinity in the haemoglobin molecule plus instability of the tetramer in the oxy conformation. Such haemoglobin has been found in North-African populations, and the case presented here is the first one reported in Spain.

[Primary sclerosing cholangitis]. / Colangitis esclerosante primaria.

The Primary Sclerosing Cholangitis, is a rare disease and the aetiology is unknown. This disease is characterized by an intense inflammation and usually fibrosis of the intra and extrahepatic portion of the biliary tree.

Colangitis esclerosante primaria. / [Primary sclerosing cholangitis]

The Primary Sclerosing Cholangitis, is a rare disease and the aetiology is unknown. This disease is characterized by an intense inflammation and usually fibrosis of the intra and extrahepatic portion of the biliary tree.