Transcription Independent Stimulation of Telomerase Enzymatic Activity by HTLV-I Tax Through Stimulation of IKK.

The persistence and spreading of HTLV-I infected cells relies upon their clonal expansion through cellular replication. The development of adult T cell leukemia (ATLL) occurs decades following primary infection by HTLV-I. Moreover, identical provirus integration sites have been found in samples recovered several years apart from infected individuals. These observations suggest that infected cells persist in the host for an extended period of time. To endure long term proliferation, HTLV-I pre-leukemic cells must acquire critical oncogenic events, two of which are the bypassing of apoptosis and replicative senescence. In the early stages of disease, interleukin-2 (IL-2)/IL-2R signaling likely plays a major role in combination with activation of anti-apoptotic pathways. Avoidance of replicative senescence in HTLV-I infected cells is achieved through reactivation of human telomerase (hTERT). We have previously shown that HTLV-I viral Tax transcriptionally activates the hTERT promoter. In this study we demonstrate that Tax can stimulate hTERT enzymatic activity independently of its transcriptional effects. We further show that this occurs through Tax-mediated NF-KB activating functions. Our results suggest that in ATLL cells acquire Tax-transcriptional and post-transcriptional events to elevate telomerase activity.

Correlación de resultados de los métodos diagnósticos de las patologías del cuello uterino en el Hospital “Camilo Cienfuegos”

Introducción:El cáncer cérvico uterino es la segunda neoplasia más común en mujeres en el mundo. Una buena correlación entre las pruebas de tamizaje, diagnóstico y tratamiento de las lesiones cervicales optimiza su manejo, evita procedimientos innecesarios y maximiza recursos disponibles.Objetivo:Identificar la relación entre los métodos diagnósticos de las patologías del cuello uterino.Métodos:Se realizó un estudio observacional, descriptivo, transversal y prospectivo en el Hospital Provincial “Camilo Cienfuegos” de Sancti Spíritus, desde septiembre de 2015 a septiembre de 2017. Se tomó una población de 1172 pacientes de la consulta de patología de cuello uterino según los criterios de la investigación. Los métodos científicos fueron: de nivel teórico, empírico-experimental y matemático-estadístico. Se asumieron las variables: edad, factores de riesgo asociados, sintomatología, citología, colposcopia y biopsia.Resultados:El grupo de edad que con mayor frecuencia se presentó estuvo comprendido entre 26 y 35 años de edad. Los principales factores de riesgo asociados fueron: edad de inicio de las relaciones sexuales antes de los 18 años, virus del papiloma humano, paridad de más de dos hijos y antecedentes familiares de alguna patología de cuello. La sintomatología destacada fue el sangramiento poscoital e intermenstrual. Los resultados de los métodos diagnósticos fueron: virus del papiloma humano y displasia leve, tanto en la citología como en la biopsia, y lesiones de bajo grado en la colposcopia.Conclusiones:La asociación entre los métodos diagnósticos estudiados mostró una buena correlación citocolposcópica y colpohistológica, con diagnóstico de confirmación principalmente ante lesiones de alto grado.[AU]

Ketamine for chronic non-cancer pain: A meta-analysis and trial sequential analysis of randomized controlled trials.

BACKGROUND: Ketamine has been suggested to be efficient in relieving chronic pain. However, there is inconsistency across studies investigating the effect of ketamine for chronic pain management. We aimed to perform a meta-analysis in order to assess the efficacy of this compound during chronic non-cancer pain conditions. METHODS: The study consisted in a meta-analysis of clinical trials comparing ketamine to a placebo during chronic non-cancer pain. The primary endpoint of this study was pain relief 4 weeks after the beginning of treatment. Secondary outcomes were: pain relief 1, 2, 8 and 12 weeks after the beginning of treatment and incidence of psychedelic manifestations. RESULTS: Six studies were included in this meta-analysis. Overall, 99 patients received ketamine and 96 received placebo. Ketamine did not decrease pain intensity at 4 weeks (MD (on a 0 to 10 scale) = -1.12 [-2.33, 0.09], GRADE evidence: very low). However, analysing studies with no high-risk bias found ketamine to decrease pain intensity at 4 weeks and increased the level of GRADE evidence to moderate. Trial sequential analysis confirmed the overall result and revealed the lack of power of this meta-analysis. Ketamine also decreased pain intensity at all other evaluated points in time. Ketamine increased the incidence of psychedelic manifestations in comparison to placebo. CONCLUSION: Results of this meta-analysis found moderate evidence suggesting the efficacy of ketamine during chronic pain. Further studies are warranted to conclude about the effect of ketamine during chronic pain conditions and to determine optimal administration regimes of this agent during this condition. SIGNIFICANCE: Ketamine has been found interesting for managing chronic pain. We performed a meta-analysis aiming to confirm those results. Ketamine was found efficient in alleviating pain up to 12 weeks after the beginning of treatment. However, overall evidence favouring the use of this compound was very low.

Validation of a simple tool for anxiety trait screening in children presenting for surgery.

BACKGROUND.: Screening for preoperative anxiety is an important challenge during the preoperative period. The aim of our study was to validate the faces scale used to detect anxiety trait in children. METHODS.: Children aged 8-18 yr were asked to quantify their anxiety trait using the readily available faces scale and to respond to the trait component of the State-Trait Anxiety Inventory (STAI) for children (C) or adults (A) before the anaesthesia consultation. Using receiver operating characteristics analysis, we determined the faces scale optimal value on a construct cohort. A validation cohort was recruited to assess the accuracy of the results. RESULTS.: The construction cohort comprised 207 patients and the validation cohort 91 patients. The receiver operating characteristics analysis found an area under the curve of 0.75 [95% confidence interval (CI) 0.67, 0.83]. The optimal value for faces scale score was 4, with a sensitivity of 0.61 [95% CI 0.59, 0.62] and a specificity of 0.82 [95% CI 0.81, 0.83]. When this threshold was applied to the construction and validation cohorts, 61.3 and 44.4% of positives were true positives in the construction and validation cohorts, respectively; and 82.1 and 81.3% of negatives were true negatives, respectively. CONCLUSIONS.: Our study determined the performance of a simple faces scale to measure the preoperative anxiety trait in children aged 8-18 yr. This tool is potentially helpful for clinicians aiming to identify patients at risk of preoperative anxiety and to assign them to targeted management.

Photodynamic therapy for the treatment of complex anal fistula.

BACKGROUND: Photodynamic therapy (PDT) is a new procedure for the treatment of anal fistula. This preliminary study was designed to investigate the safety and effectiveness of this new technique in the treatment of anal fistula. METHODS: Ten patients were treated with PDT. Intralesional 5-aminolevulinic acid (ALA) 2% was directly injected into the fistula. The internal and external orifices were closed. After an incubation period of 2 h, the fistula was irradiated using an optical fibre connected to a red laser (MULTIDIODE 630 PDT, INTERmedic, Spain) operating at 1 W/cm for 3 min (180 Joules). Patient demographics, operation notes and complications were recorded. RESULTS: There were no complications. The average length of patient follow-up was 14.9 months (range 12-20 months). We could observe primary healing in eight patients (80%). Two patients (20%) showed persistence of suppuration after the operation. No patient reported incontinence postoperatively. CONCLUSIONS: PDT is a potential sphincter-saving procedure that is safe, simple and minimally invasive and has a high success rate.

Tumores extramucosos de colon: diagnóstico diferencial / Extramucosal colon tumors: differential diagnosis

Los tumores estromales o mesenquimáticos derivan de la pared extramucosa del tubo digestivo y constituyen un grupo raro de tumores originados del tejido conectivo. Presentamos dos casos clínicos, en lo que la sospecha diagnóstica inicial era GIST pero tras intervención quirúrgica y resultado anatomo-patológico se evidenció la existencia de tumor fibroso solitario y lipoma, descartando por tanto la existencia de GIST. Es fundamental, por tanto, llevar a cabo un diagnóstico diferencial de estos tumores extramucosos ya que el tratamiento y el seguimiento dependeran de la entidad

Mesenchymal or stromal tumors derived from extramucosal gut wall and are a rare group of tumors caused connective tissue. We present two cases in which the initial diagnostic suspicion was but after GIST surgery and anatomy-pathological result was evidence of solitary fibrous tumor and lipoma, thus ruling out the existence of GIST. It is essential therefore to carry out a differential diagnosis of these tumors extramucosal as treatment and monitoring depend on the entity

Estrategia multimodal para la prevención de la infección relacionada con la asistencia sanitaria en el Servicio de Angiología y Cirugía Vascular / Multimodal strategy for the prevention of health care-associated infections in the angiology and vascular surgery department

INTRODUCCIÓN: Las infecciones relacionadas con la asistencia sanitaria (IRAS) son, actualmente, un problema importante de seguridad del paciente (SP) en los servicios quirúrgicos. El objetivo es describir la estrategia multimodal para la prevención de la infección relacionada con la asistencia sanitaria en el Servicio de Angiología y Cirugía Vascular (SACV) de un hospital de segundo nivel. MATERIAL Y MÉTODOS: La estrategia se llevó a cabo a lo largo de 17 meses en el Hospital Universitario San Cecilio, Granada. Se realizaron 4 actividades: 1) vigilancia activa de la IRAS y feedback a los profesionales; 2) medición del grado de contaminación de las manos del personal, evaluación de la técnica de higiene de manos (HM) y feedback a los profesionales; 3) organización de un curso específico sobre SP; 4) elaboración de material formativo. RESULTADOS: Se registró una reducción porcentual de IRAS de 22,69% entre el inicio y el final de la intervención. Además, hubo diferencias estadísticamente significativas entre los recuentos microbiológicos de las manos de los profesionales a lo largo del proceso. El curso formativo registró una satisfacción general media superior al 95%. Se elaboraron 3 documentos gráficos recordatorios. CONCLUSIONES: La estrategia para la prevención de las IRAS en el SACV supuso mejoras en cuestiones de SP. Se ha conseguido sensibilizar a los profesionales sobre la importancia de «trabajar con seguridad» y se ha registrado una reducción porcentual de la tasa de incidencia de IRAS entre 2011 y 2012. El trabajo en equipo fue fundamental para el desarrollo de todo el proceso

INTRODUCTION: Health Care-Associated Infections (HCAI) are currently a significant patient safety (PS) problem in surgical departments. The aim of this article is to describe the multimodal strategy for the prevention of health care associated infection in the Angiology and Vascular Surgery Department (AVSD) of a secondary level hospital. MATERIAL AND METHODS: The strategy was implemented for 17 months in the San Cecilio University Hospital, Granada. Four activities were carried out: 1) active surveillance of HCAI and feedback to the professionals; 2) measurement of the level of contamination of the hands of the personnel, assessment of the hand hygiene (HH) technique and feedback to the professionals; 3) organising a specific course on PS; and 4) preparation of training material. RESULTS: A 22.69% decrease in HCAI between the start and end of the intervention was recorded. There were also statistically significant differences in the microbiology counts on the hands of the professional throughout the process. The training course recorded a mean general satisfaction of over 95%. Three reminder graphs were also prepared. CONCLUSIONS: The strategy for the prevention of HCAI in the AVSD showed improvements as regards patient safety. It has managed to make professionals more aware of the importance of «to work with safety», and has recorded a percentage reduction in the HCAI incidence rate between 2011 and 2012. Teamwork was fundamental for the development of the whole process

Neumoperitoneo secundario al lavado quirúrgico de absceso isquiorrectal con agua oxigenada / Pneumoperitoneum secondary to ischiorectal abscess surgical scrub with hydrogen peroxide

El agua oxigenada es una sustancia usada frecuentemente como un agente seguro e inocuo; sin embargo, se han descrito diversas complicaciones que establecen la voz de alarma sobre su uso. Presentamos un caso de neumoperitoneo secundario al lavado quirúrgico con agua oxigenada en un paciente con diagnóstico de absceso isquiorrectal. Ante las complicaciones observadas del uso de una sustancia tan ampliamente extendida en cirugía, debería replantearse su uso o al menos darle un empleo más restringido, en cavidades o espacios semicerrados y usar en su lugar sustancias más seguras que hasta ahora no hayan mostrado efectos tan nocivos (AU)

Hydrogen peroxide is a substance often used as a safe and harmless agent, various complications have been described that set the alarm on their use. We present a case of pneumoperitoneum secondary to surgical scrub with hydrogen peroxide in a patient with ischiorectal abscess. Given the complications of the use of a substance as widespread in surgery, we should rethink their use or at least give it more restricted use, in cavities or semi-enclosed spaces and instead use other safer chemicals (AU)

The "E" word: epilepsy and perceptions of unfair treatment from the 2010 Australian Epilepsy Longitudinal Survey.

AIM: The aim of the current study was to examine self-report data on perceptions of unfair treatment due to epilepsy. METHOD: We analyzed data from the 2010 Australian Epilepsy Longitudinal Survey, distributed to 621 registrants on the Australian Epilepsy Research Register. A total of 343 responses were received (55% response rate), providing insight into experiences of life with epilepsy in Australia. Responses relating to perceptions of unfair treatment in areas of employment, education and community participation as a result of epilepsy are reported in this article. RESULTS: Forty-eight percent of respondents reported perceptions of unfair treatment as a result of their epilepsy, with most providing details of their experiences. Discrimination in the workplace remains of key concern, with 47% citing examples of unfair treatment in this setting. CONCLUSIONS: In spite of Australian anti-discrimination laws, findings indicate that full-time employment rates for people with epilepsy are lower than previously reported, with further mechanisms for support required to improve education and reduce experiences of stigma.

Commissioning of the Varian TrueBeam linear accelerator: a multi-institutional study.

PURPOSE: Latest generation linear accelerators (linacs), i.e., TrueBeam (Varian Medical Systems, Palo Alto, CA) and its stereotactic counterpart, TrueBeam STx, have several unique features, including high-dose-rate flattening-filter-free (FFF) photon modes, reengineered electron modes with new scattering foil geometries, updated imaging hardware/software, and a novel control system. An evaluation of five TrueBeam linacs at three different institutions has been performed and this work reports on the commissioning experience. METHODS: Acceptance and commissioning data were analyzed for five TrueBeam linacs equipped with 120 leaf (5 mm width) MLCs at three different institutions. Dosimetric data and mechanical parameters were compared. These included measurements of photon beam profiles (6X, 6XFFF, 10X, 10XFFF, 15X), photon and electron percent depth dose (PDD) curves (6, 9, 12 MeV), relative photon output factors (Scp), electron cone factors, mechanical isocenter accuracy, MLC transmission, and dosimetric leaf gap (DLG). End-to-end testing and IMRT commissioning were also conducted. RESULTS: Gantry/collimator isocentricity measurements were similar (0.27-0.28 mm), with overall couch/gantry/collimator values of 0.46-0.68 mm across the three institutions. Dosimetric data showed good agreement between machines. The average MLC DLGs for 6, 10, and 15 MV photons were 1.33 ± 0.23, 1.57 ± 0.24, and 1.61 ± 0.26 mm, respectively. 6XFFF and 10XFFF modes had average DLGs of 1.16 ± 0.22 and 1.44 ± 0.30 mm, respectively. MLC transmission showed minimal variation across the three institutions, with the standard deviation <0.2% for all linacs. Photon and electron PDDs were comparable for all energies. 6, 10, and 15 MV photon beam quality, %dd(10)x varied less than 0.3% for all linacs. Output factors (Scp) and electron cone factors agreed within 0.27%, on average; largest variations were observed for small field sizes (1.2% coefficient of variation, 10 MV, 2 × 2 cm(2)) and small cone sizes (<1% coefficient of variation, 6 × 6 cm(2) cone), respectively. CONCLUSIONS: Overall, excellent agreement was observed in TrueBeam commissioning data. This set of multi-institutional data can provide comparison data to others embarking on TrueBeam commissioning, ultimately improving the safety and quality of beam commissioning.

Seizure-related injuries and hospitalizations: self-report data from the 2010 Australian Epilepsy Longitudinal Survey.

AIM: To examine self-report data on seizure-related injuries and hospitalizations. METHOD: We analyzed data from the 2010 Australian Epilepsy Longitudinal Survey, distributed to registrants on the Australian Epilepsy Research Register. 343 responses were received (55% response rate), providing insight into experiences of living with seizures. This article examines self-report data on injuries related to seizures and hospitalizations. RESULTS: 64% of those reporting injuries required hospital treatment. Respondents with seizure-related injuries had significantly earlier seizure onset, with risk of injury related to myoclonic and atonic seizures and currently taking 3 or more AEDs. Soft tissue injuries were the most frequently reported (85%), with 27% indicating facial injuries. CONCLUSIONS: The high rate of hospitalizations largely for soft tissue injuries suggests that access to more appropriate care was not available. Further research into care-seeking behavior by Australians suffering injury following seizure is required. Additionally, awareness of injury risks is important for appropriate self-management of epilepsy.

Nuclear export and expression of human T-cell leukemia virus type 1 tax/rex mRNA are RxRE/Rex dependent.

Human T-cell leukemia virus type 1 (HTLV-1) is a complex retrovirus associated with the lymphoproliferative disease adult T-cell leukemia/lymphoma (ATL) and the neurodegenerative disorder tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). Replication of HTLV-1 is under the control of two major trans-acting proteins, Tax and Rex. Previous studies suggested that Tax activates transcription from the viral long terminal repeat (LTR) through recruitment of cellular CREB and transcriptional coactivators. Other studies reported that Rex acts posttranscriptionally and allows the cytoplasmic export of unspliced or incompletely spliced viral mRNAs carrying gag/pol and env only. As opposed to HIV's Rev-responsive element (RRE), the Rex-responsive element (RxRE) is present in all viral mRNAs in HTLV-1. However, based on indirect observations, it is believed that nuclear export and expression of the doubly spliced tax/rex RNA are Rex independent. In this study, we demonstrate that Rex does stimulate Tax expression, through nuclear-cytoplasmic export of the tax/rex RNA, even though a Rex-independent basal export mechanism exists. This effect was dependent upon the RxRE element and the RNA-binding activity of Rex. In addition, Rex-mediated export of tax/rex RNA was CRM1 dependent and inhibited by leptomycin B treatment. RNA immunoprecipitation (RNA-IP) experiments confirmed Rex binding to the tax/rex RNA in both transfected cells with HTLV-1 molecular clones and HTLV-1-infected T cells. Since both Rex and p30 interact with the tax/rex RNA and with one another, this may offer a temporal and dynamic regulation of HTLV-1 replication. Our results shed light on HTLV-1 replication and reveal a more complex regulatory network than previously anticipated.

SU-E-T-107: Uncertainty Estimate of a Practical EBT-2 Film Dosimetry Approach: Transpose-And-Scan Technique.

PURPOSE: To estimate the uncertainty of a practical EBT2 film dosimetry approach that has been established at our institution and used for routine patient-specific plan verifications, particularly for SBRT and RapidArc, as well as planning system commissioning. Our technique is unique from other common dosimetry protocols with respect to calibration, irradiation and scanning. METHODS: Film dosimetry for patient-specific quality assurance of 29 patient plans were retrospectively reviewed. For each case, four films were irradiated; two for calibration and two for treatment plan. Each pair of two films were irradiated together in a phantom with one film transposed (rotated 180 degrees relative to the other) to compensate for asymmetric film response. After a minimum of 12 hrs post-irradiation, each film was scanned in four different orientations to mitigate non-uniform response of the scanner light and detector elements. The scanned 8 calibration and 8 plan images were averaged into one calibration and one plan film image, respectively. Each color channel of the calibration film was correlated to the reference dose matrix to produce a 3rd order polynomial calibration curve. Finally, each color channel of the plan film was converted to a dose map using the corresponding calibration curve. Average dose maps of the red and green channels were correlated to the treatment planning dose matrix, and the mean dose differences at the center of dose distributions (5×5mm̂2 area) as well as a gamma analysis were evaluated. RESULTS: The absolute dose differences were -0.8±1.7% (range=-4.5-3.0%). The gamma pass-rates (3%/3mm) were 94±7% (min.=74%). The pass rate increased to 99±3%(min.=87%) with the film scaled relatively to the plan doses. CONCLUSIONS: Based on a large number of cases, our approach appears to be robust to non-uniform film and scanner responses, and is shown to have an uncertainty (1SD) of less than 2% for absolute film dosimetry.

Gastric emptying of a liquid nutrient meal in the critically ill: relationship between scintigraphic and carbon breath test measurement.

OBJECTIVE: It is assumed that delayed gastric emptying (GE) occurs frequently in critical illness; however, the prevalence of slow GE has not previously been assessed using scintigraphy. Furthermore, breath tests could potentially provide a convenient method of quantifying GE, but have not been validated in this setting. The aims of this study were to (i) determine the prevalence of delayed GE in unselected, critically ill patients and (ii) evaluate the relationships between GE as measured by scintigraphy and carbon breath test. DESIGN: Prospective observational study. SETTING: Mixed medical/surgical intensive care unit. PATIENTS: 25 unselected, mechanically ventilated patients (age 66 years (49-72); and 14 healthy subjects (age 62 years (19-84)). INTERVENTIONS: GE was measured using scintigraphy and (14)C-breath test. A test meal of 100 ml Ensure (standard liquid feed) labelled with (14)C octanoic acid and (99m)Technetium sulphur colloid was placed in the stomach via a nasogastric tube. MAIN OUTCOME MEASURES: Gastric 'meal' retention (scintigraphy) at 60, 120, 180 and 240 min, breath test t(50) (BTt(50)), and GE coefficient were determined. RESULTS: Of the 24 patients with scintigraphic data, GE was delayed at 120 min in 12 (50%). Breath tests correlated well with scintigraphy in both patients and healthy subjects (% retention at 120 min vs BTt(50); r(2)=0.57 healthy; r(2)=0.56 patients; p≤0.002 for both). CONCLUSIONS: GE of liquid nutrient is delayed in approximately 50% of critically ill patients. Breath tests correlate well with scintigraphy and are a valid method of GE measurement in this group.

Recomendaciones de calidad para el diagnóstico prenatal molecular / Quality recommenations in molecular prenatal diagnosis

El diagnóstico prenatal molecular consiste en la aplicación de técnicas de genética molecular sobre una muestra fetal obtenida generalmente mediante una técnica invasiva con el objetivo de diagnosticar una determinada enfermedad hereditaria ante un riesgo clínico evidente. Desde que en 1975 se realizara el primer diagnóstico prenatal molecular hasta la fecha, el panorama ha cambiado considerablemente. El descubrimiento y aplicación de nuevas técnicas moleculares, la mejora de las técnicas invasivas con la consiguiente reducción del riesgo de pérdida fetal y, en particular, la gran experiencia adquirida en las unidades multidisciplinaresde genética han convertido al diagnóstico prenatalmolecular en una opción diagnóstica rutinaria con una importante demanda social. Además, el número de enfermedades hereditarias que pueden ser diagnosticadas y el número de mutaciones identificadas en pacientes afectados por enfermedades raras es cada vez mayor, lo que posibilita cada vez más la aplicación de esta opción diagnóstica. Ante esta situación de crecimiento, tanto en cantidad de diagnósticos como en su diversidad y complejidad, y teniendo en cuenta las importantes implicaciones, tanto hereditarias como éticas y sociales, resulta necesario disponer de unos criteriosmínimos de calidad que garanticen un adecuado diagnósticoprenatal y de este modo posibilitar la posterior toma dedecisiones. Estas recomendaciones deben tener en cuentano sólo los aspectos técnicos que rodean el análisis de la muestra de ADN fetal, sino también la planificación previa y la viabilidad de un determinado tipo de diagnóstico, así como la correcta interpretación y comunicación a la pareja de las implicaciones de los resultados obtenidos

The molecular prenatal diagnosis consists in theapplication of molecular genetics techniques on a foetalsample obtained, generally, using an invasive techniqueto diagnose a particular inherited disease when an evident clinical risk is present. Since in 1975 the first molecular prenatal diagnosis was performed up to now, the picture has changed considerably. The discovery and implementation of new molecular techniques, the improving of the invasive techniques with a consequent reduction of the risk for foetal loss and in particular the great experience acquired in the multidisciplinary genetics units have become the molecular prenatal diagnosis in a routine diagnostic option with an important social demand. In addition, the number of inherited diseases that can be diagnosed and the number of mutations identified in patients affected by rare diseases is increasing, enabling more and more the application of this diagnosis option. In this situation of growth, both in quantity of diagnoses as in its diversity and complexity, and taking into account the important implications, not only hereditary but also ethical and social, is necessary to have minimum of quality standards in order to guarantee an adequate prenatal diagnosis and thus enabling the subsequent decision making process. These recommendationsshould take into account, not just the technicalaspects surrounding the analysis of the sample offoetal DNA, but also the planning and the feasibility of a particular type of diagnosis, as well as the correct interpretation and communication of all the results implications to the couple (AU)

Enfermería hospitalaria. Funciones propias / Hospital nursing: its own functions

Se investiga el grado de cumplimiento de las funciones de enfermería hospitalaria, el modo y las actitudes con que la enfermera las realiza, y su grado de interdependencia y condicionamiento mutuo. Para ello se ha realizado un análisis teórico y un trabajo de campo que han contribuido a la obtención de diversas conclusiones (AU)

[Hospital nursing: its own functions]. / Enfermería hospitalaria. Funciones propias.

The author investigates the degree of compliance of nursing functions in hospitals, the manner and the attitudes with which a nurse carries out these functions, and their degree of interdependence and mutual conditioning. To these ends, the author has carried out a theoretical analysis and a field investigation which have helped obtain diverse conclusions.