NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care.

AIM: To determine the prevalence of NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care setting. DESIGN: Retrospective descriptive study of electronic record review. METHODS: Eight thousand three hundred three episodes recorded during the year 2019 were recovered from the electronic health records of a public emergency care agency. The prevalence of NANDA International nursing diagnosis, Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions was determined. A cross-tabulation analysis was performed to determine the linkages. Data were accessed in November 2020. RESULTS: NANDA International nursing diagnoses Anxiety (00146) and Fear (00148) represented more than 90% of the diagnoses recorded in the domain. Anxiety level (1211) and emotional support (5270) were the most recorded Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions, with almost 20% and 5% of total records, respectively. The linkage between nursing diagnosis Anxiety (00146), outcome Anxiety level (1211) and intervention Anxiety reduction (5820) was the most recorded with slightly more than 3% of the total. CONCLUSION: Eight different NANDA International nursing diagnoses in the coping/stress tolerance domain were recorded. Nursing Outcomes Classification outcomes were selected aimed mainly at psychological well-being and Nursing Interventions Classification interventions to support coping. In general, linkages were aimed to provide emotional support, physical well-being, information, education and safety. IMPACT: This study showed that pre-hospital emergency care nurses diagnose and treat human responses in the coping/stress tolerance domain. Expert consensus-based linkages may be complemented by the results of this study, increasing the levels of evidence of both individualized and standardized care plans for critical patients assisted by pre-hospital emergency care nurses.

Comparison of condylar position in normal occlusion, Class II Division 1, Class II Division 2 and Class III malocclusions using CBCT imaging.

BACKGROUND: The aim of this study was to establish the condylar position in a group of patients with normal occlusion, compared to Class II Div 1, Class II Div 2 and Class III malocclusions using CBCT imaging. MATERIAL AND METHODS: Retrospective case-control study carried out by analyzing CBCT images of 80 patients. The sample was divided into 4 different groups with 20 patients each (40 TMJ). All patients were positioned using the Frankfurt plane, parallel to the floor and in maximum intercuspation. The control group included asymptomatic patients with normal occlusion (Less than 2mm of tooth size-arch length discrepancy, positive or negative, 0-2mm overjet, 2-4mm overbite, less than 15o rotations, without facial asymmetries, no previous orthodontic or occlusal treatment, without muscular or articular signs or symptoms in both TMJs) and the experimental group with (class II/1, II/2 and III) malocclusions. RESULTS: The group with normal occlusion had the condyles centrally positioned within the glenoid fossa. The values obtained in this group were considered as optimal and when compared with the other groups with malocclusions. The results established that the position of the condyle was more posterior in class II/2 and more superior in class III patients than the asymptomatic normal occlusion group. CONCLUSIONS: The data obtained in the asymptomatic group with normal occlusion could be used as a reference for future studies. The comparison of these values with those obtained from analyzing the different sagittal malocclusions show significant differences that could be valuable when establishing the diagnosis and the objectives of the treatment plan in orthodontics. Key words:Condylar position, CBCT, dental malocclusion and condylar concentricity.

Virtual surgery for patients with nasal obstruction: Use of computational fluid dynamics (MeComLand®, Digbody® & Noseland®) to document objective flow parameters and optimise surgical results. / Cirugía virtual para pacientes con obstrucción nasal: empleo de un software basado en dinámica de fluidos (MeComLand®, Digbody® & Noseland®) para documentar parámetros objetivos de flujo y optimizar resultados quirúrgicos.

INTRODUCTION: Computational fluid dynamics (CFD) is a mathematical tool to analyse airflow. We present a novel CFD software package to improve results following nasal surgery for obstruction. METHODS: A group of engineers in collaboration with otolaryngologists have developed a very intuitive CFD software package called MeComLand®, which uses the patient's cross-sectional (tomographic) images, thus showing in detail results originated by CFD such as airflow distributions, velocity profiles, pressure, or wall shear stress. NOSELAND® helps medical evaluation with dynamic reports by using a 3D endoscopic view. Using this CFD-based software a patient underwent virtual surgery (septoplasty, turbinoplasty, spreader grafts, lateral crural J-flap and combinations) to choose the best improvement in nasal flow. OBJECTIVE: To present a novel software package to improve nasal surgery results. To apply the software on CT slices from a patient affected by septal deviation. To evaluate several surgical procedures (septoplasty, turbinectomy, spreader-grafts, J-flap and combination among them) to find the best alternative with less morbidity. RESULTS: The combination of all the procedures does not provide the best nasal flow improvement. Septoplasty plus turbinoplasty obtained the best results. Turbinoplasty alone rendered almost similar results to septoplasty in our simulation. CONCLUSIONS: CFD provides useful complementary information to cover diagnosis, prognosis, and follow-up of nasal pathologies based on quantitative magnitudes linked to fluid flow. MeComLand®, DigBody® and NoseLand® represent a non-invasive, low-cost alternative for the functional study of patients with nasal obstruction.

Psicosis, psicotico / Psychosis, psychotic

El enigma que aún hoy constituye el problema de la psicosis posiblemente deriva de un error de plantamiento, a partir del cual toda investigación, de la índole que sea, está condenada a la esterilidad. Urge, más que otra cosa, la construcción de un paradigma, de una teoría desde la que interpretar los hechos, eludiendo esa tarea habitual que consiste en la selección de sólo aquellos que se acomodan a nuestros pre-juicios y parecen, por tanto, confirmarlos y dotarlos de rango de cientificidad. Es imprescindible una teoría general de la locura desde la cual ir a la realidad que compone el mundo de los seres humanos con sus relaciones entre sí y con los demás objetos externos e internos, y detectar, así, cuáles de ellos ostentan, transitoria o permanentemente, y en mayor o menor cuantía, síntomas o conducta psicóticas. La realidad se ha de explicar desde la teoría, y ésta se ha de confirmar o no en la realidad