Intervenciones de enfermería psicoeducativas presenciales y on-line, para el manejo de la ansiedad: revisión integradora de la literatura / Face-to-face and online psychoeducational nursing interventions for anxiety management: an integrative review of the literatura

Objetivo: analizar las evidencias encontradas en la literatura científica sobre el impacto de las intervenciones psico-educativas en el manejo de la ansiedad, desarrolladas en línea o presenciales con participación de profesionales de enfermería. Método: revisión narrativa e integradora de literatura científica mediante la búsqueda de publicaciones en los principales metabuscadores y en los artículos indexados de las bases de datos de SciELO, MEDLINE y LILACS. Resultados/Discusión: la búsqueda de artículos basados en intervenciones psico-educativas en línea para el manejo de la ansiedad y enfermería, aportó 4.295 publicaciones que, tras las tres etapas de lectura y filtrado, sólo 11 fueron seleccionados: dos revisiones sistemáticas, ocho ECAs y un estudio cuasiexperimental. El aspecto psico-educativo es transversal en cada publicación, siendo efectivo para el manejo de la ansiedad en diversas situaciones clínicas. Aunque hay diversos estudios que evidencian la realización de intervenciones psico-educativas presenciales lideradas por enfermería, no se encontró ningún estudio o investigación específica desarrollada por enfermeras íntegramente en formato on-line. Conclusión: Las modalidades de intervención, estrategias y programas psico-educativos que aprovechan la facilidad de uso e impacto que aporta el uso de las TICs, deben ser valorados desde el ámbito clínico de forma más exhaustiva, ya que estas herramientas facilitan la incorporación de la psico-educación en la rutina clínica. La falta de evidencia sobre la eficacia de estas intervenciones cuando son diseñadas y desarrolladas íntegramente por enfermeras hace necesario plantear investigaciones que evalúen sus resultados. (AU)

Objective: To analyze the evidence found in the scientific literature of the impact of psycho-educational interventions on anxiety management, carried out online or in person with the participation of nursing professionals. Method: Narrative and integrative review of scientific literature by searching for publications in the main metasearch engines and in the indexed articles of the SciELO, MEDLINE and LILACS databases. Results/Discussion: The search for articles based on online psycho-educational interventions for anxiety management and nursing, provided 4,295 publications, of which, after the three stages of reading and filtering, only 11 were selected: two systematic reviews, eight RCTs and one quasi-experimental study. The psycho-educational aspect is transversal in each publication, being effective for the management of anxiety in various clinical situations. Although there are several studies that show the realization of face-to-face psycho-educational interventions led by nursing, we did not find any specific investigation or research carried out by nurses in an entirely online format. Conclusion: The intervention modalities, strategies and psycho-educational programs that take advantage of the ease of use and impact provided using ICT should be evaluated from the perspective of the clinical field in a more exhaustive way, since these tools facilitate the incorporation of psychoeducation into the clinical routine. The lack of evidence on the efficacy of these interventions when they are designed and implemented entirely by nurses makes it necessary to propose research that evaluates the results. (AU)

Infección necrotizante de tejidos blandos: experiencia durante 15 años en un hospital pediátrico / Necrotizing soft tissue infections: experience over 15 years in a pediatric hospital

INTRODUCCIÓN: La Infección Necrotizante de tejidos blandos (INTB) tiene una elevada morbimortalidad. El objetivo de este trabajo es describir del manejo perioperatorio de menores de 15 años que cursaron con INTB durante 15 años en un Hospital pediátrico. MATERIAL Y MÉTODOS: serie de pacientes identificados INTB entre 2000 y 2015 en el Hospital Roberto del Río. Se describen variables demográficas, clínicas, vacuna, tratamiento, cirugías, complicaciones, microorganismos, seguimiento, y fallecimientos. RESULTADOS: 22 pacientes, con mediana de 2 años y 9 meses de edad. 50% estaban cursando con una varicela. Dos fallecieron. Ninguno era previamente vacunado contra el virus varicela zoster. La localización fue tronco (14), extremidades (7), cuello (1). Los pacientes conscientes presentaron hiperestesia cutánea. Se realizó aseo quirúrgico con una mediana de 6,8 horas desde el inicio de la hiperestesia y 2 horas desde la sospecha diagnóstica. Los microorganismos fueron: S. pyogenes (38%) y E. coli (31%). Los antibióticos más frecuentes fueron penicilina más clindamicina. La herida se manejó con cierre primario, injertos y/o colgajos. Cinco evolucionaron con secuelas que necesitaron tratamiento. CONCLUSIÓN: Se identificó que la INTB puede presentarse con varicela. Debe sospecharse en lesiones cutáneas e hiperestesia desproporcionada. Resección amplia y precoz son fundamentales para el tratamiento.

INTRODUCTION: Necrotizing soft tissue infection (NSTI) has a high morbidity and mortality. The objective of this study is to describe the perioperative management of children under 15 years of age who have had this condition for 15 years in a pediatric hospital. MATERIAL AND METHODS: cases series of patients identified by Pathological Anatomy with NSTI during 2000 and 2015 at the Dr. Roberto del Río Hospital. Demographic variables, treatment, antecedents of vaccination, surgeries, complications, microorganisms, follow-up, and deaths are described. RESULTS: 22 patients were identified, with a median of 2 years 9 months of age (interquartile range: 13 months to 5 years y 10 months). 50% of the cases were associated to chickenpox. Two died. No patient was previously vaccinated against varicella zoster virus. The location was trunk (14), extremities (7) and neck (1). All conscious patients presented cutaneous hyperesthesia. Surgical debridement was performed with a median of 6.8 hours from the onset of hyperesthesia and 2 hours from diagnostic suspicion. The most frequent microorganisms were: Streptococcus pyogenes (38%) and Escherichia coli (31%). The most frequent antibiotics used were penicillin plus clindamycin. The wound was handled with primary closure, grafts and / or flaps. Five patients evolved with sequelae that needed treatment. CONCLUSION: It was identified that STNI in children is associated with chickenpox. It should be suspected in cutaneous lesions and disproportionate hyperesthesia. Aggressive resection is essential for treatment

Communal nesting and kinship in degus (Octodon degus).

Communal nesting is a fundamental component of many animal societies. Because the fitness consequences of this behavior vary with the relatedness among nest mates, understanding the kin structure of communally nesting groups is critical to understanding why such groups form. Observations of captive degus (Octodon degus) indicate that multiple females nest together, even when supplied with several nest boxes. To determine whether free-living degus also engage in communal nesting, we used radiotelemetry to monitor spatial relationships among adult females in a population of O. degus in central Chile. These analyses revealed that females formed stable associations of > 2-4 individuals, all of whom shared the same nest site at night. During the daytime, spatial overlap and frequency of social interactions were greatest among co-nesting females, suggesting that nesting associations represent distinct social units. To assess kinship among co-nesting females, we examined genotypic variation in our study animals at six microsatellite loci. These analyses indicated that mean pairwise relatedness among members of a nesting association (r=0.25) was significantly greater than that among randomly selected females (r=-0.03). Thus, communally nesting groups of degus are composed of female kin, making it possible for indirect as well as direct fitness benefits to contribute to sociality in this species.