The erector spinae plane block: a narrative review.

Regional anesthesia and pain management have experienced advances in recent years, especially with the advent of fascial plane blocks. The erector spinae plane block is one of the newest techniques to be described. In the past two years, publications referring to ESP block have increased significantly. The objective of this review is to analyze the articles about ESP block that have been published to date. We performed a search in the main databases and identified 368 articles. After a selection of the relevant articles, 125 studies were found eligible and were included in the review. The ESP block is performed by depositing the local anesthetic in the fascial plane, deeper than the erector spinae muscle at the tip of the transverse process of the vertebra. Many cases of its use have been described with satisfactory results in the treatment of both acute pain and chronic pain. The applicability of the technique covers many clinical scenarios. Of the 98 case reports reviewed, 12 and 87 articles, respectively described the technique as a treatment for chronic pain and acute pain. The single-shot was the most frequently used technique. As described in the articles published to date, the technique is easy to perform and has a low rate of complications. However, despite the effectiveness of the technique, further studies are necessary to obtain more evidence of its actions.

El proceso enfermero en la administración de vacunas / The nursing process in the administration of vaccines

Objetivo: identificar los elementos del proceso enfermero (diagnósticos de Enfermería, criterios de resultado NOC, intervenciones de Enfermería NIC) relacionados con la administración de vacunas con el propósito de elaborar una guía clínica que además facilite el uso de registros informatizados. Método: búsqueda bibliográfica en bases de datos en castellano, con las palabras clave: proceso & atención & enfermera & vacuna; atención &enfermería & vacuna; vacunación & NIC & NOC, o NIC & NOC &plan de cuidados & vacunación o plan de cuidados & vacunación. Elaboración de un listado de posibles diagnósticos enfermeros usando la clasificación NANDA, elección de los criterios de resultados (NOC) e intervenciones de Enfermería (NIC) asociados. Elaboración de parrilla aunando diagnósticos NANDA con criterios de resultados (NOC) e intervenciones de Enfermería (NIC).Resultados: cuando la actitud del usuario es positiva hacia el acto vacunal, los planes de cuidados para este proceso pueden agruparse en el diagnóstico Disposición para mejorar el estado de inmunización (00186). A partir de los diagnósticos, y para cada uno de ellos, se desarrollan los criterios de resultados (NOC) y las intervenciones de Enfermería (NIC) pertinentes. Conclusiones: la utilización de planes de cuidados estandarizados, al contemplar los diagnósticos, resultados e intervenciones enfermeras, facilitan que el profesional tenga una visión general de los cuidados a prestara cada usuario, facilitando a focalización y potenciando la individualización al tener en cuenta la idiosincrasia de cada persona (AU)

Objective: identify the elements of nursing process (nurse diagnoses, NOC nursing outcomes, NIC nursing interventions) related to vaccine administration in order to develop a clinical guideline which also facilitates the use of computerized records. Method: bibliographic search in databases in Spanish, with key words: process & attention & nurse & vaccine; attention & nursing & vaccine; vaccination & NIC & NOC, or NIC & NOC & care plan & vaccination or care plan & vaccination. Elaboration of a list of possible nursing diagnoses using the NANDA classification, selection of outcome criteria (NOC) and associated nursing interventions (NIC). Elaboration of a table template grouping NANDA diagnoses with outcome criteria (NOC) and nursing interventions (NIC).Results: when the attitude of the user is positive towards the act of vaccination, care plans for this process may be grouped under “Disposition/Readiness” to improve the state of immunization (00186). Using the diagnoses as the start point, and for each of these diagnoses, outcome criteria (NOC) and the pertinent nursing interventions (NIC) will be developed. Conclusions: the utilisation of standardised care plans when assessing diagnoses, outcomes and nursing interventions make it possible for the professional to have a general vision of the care to be given to each user, facilitating focalisation and enhancing individualisation by taking into account the idiosyncrasy of each individual (AU)

The depletion of nuclear glutathione impairs cell proliferation in 3t3 fibroblasts.

BACKGROUND: Glutathione is considered essential for survival in mammalian cells and yeast but not in prokaryotic cells. The presence of a nuclear pool of glutathione has been demonstrated but its role in cellular proliferation and differentiation is still a matter of debate. PRINCIPAL FINDINGS: We have studied proliferation of 3T3 fibroblasts for a period of 5 days. Cells were treated with two well known depleting agents, diethyl maleate (DEM) and buthionine sulfoximine (BSO), and the cellular and nuclear glutathione levels were assessed by analytical and confocal microscopic techniques, respectively. Both agents decreased total cellular glutathione although depletion by BSO was more sustained. However, the nuclear glutathione pool resisted depletion by BSO but not with DEM. Interestingly, cell proliferation was impaired by DEM, but not by BSO. Treating the cells simultaneously with DEM and with glutathione ethyl ester to restore intracellular GSH levels completely prevented the effects of DEM on cell proliferation. CONCLUSIONS: Our results demonstrate the importance of nuclear glutathione in the control of cell proliferation in 3T3 fibroblasts and suggest that a reduced nuclear environment is necessary for cells to progress in the cell cycle.