Uso de las bases de datos científicas en estudiantes de enfermería: factores influyentes / Scientific databases use among nursing students: related factors / Uso das bases de dados científicas em estudantes de enfermagem: fatores influentes

Resumen Introducción El Modelo de Aceptación Tecnológica (TAM), ha sido ampliamente utilizado para predecir el uso de bases de datos científicas (BDC). No obstante, es preciso indagar el peso de otras variables identificadas en la revisión de la literatura. Objetivo: Identificar los factores influyentes en la aceptación y uso de las bases de datos científicas por parte de los estudiantes de la carrera de enfermería de una universidad privada. Método El estudio tiene un diseño no experimental, transversal de tipo descriptivo y correlacional. Se aplicó un cuestionario a estudiantes de la carrera de Enfermería (Chile). Se realizó un análisis basado en regresión de mínimos cuadrados parciales en SmartPLS. Resultados Se corroboran como variables predictoras del uso de BDC a las variables TAM (intención de uso, utilidad y facilidad de uso) y a otras variables externas al modelo (obligatoriedad, las habilidades informacionales y el entrenamiento en tecnologías). Discusión La evidencia identifica que una de las principales barreras en el uso de las BDC son las habilidades informacionales y digitales para su utilización. Conclusiones Se hace necesario incorporar nuevas metodologías para aumentar la competencia de los estudiantes con el uso de estas bases, para este efecto se consideraron las variables que resultaron predictoras.

Abstract Introduction The Technology Acceptance Model (TAM) has been extensively utilized to predict the use of scientific databases; nevertheless, it is necessary to further inquire on the weight of other literature review identified variables. Objective To identify factors influencing the acceptance and use of scientific databases by nursing students in a private university. Method This is a correlational, descriptive, transversal, and non-experimental study. A corresponding questionnaire was distributed among nursing students in Chile. A partial least squares regression analysis was performed using SmartPLS. Results TAM predicting variables to the usage of scientific databases, including intention to use, usefulness, and ease of use, were corroborated. Other TAM-external predicting variables such as obligatoriness, information-handling skills, and technology training, were also found. Discussion Evidence suggested that a main barrier to the use of scientific databases refers to the skills to handle digital information. Conclusions Considering the related predicting variables, it is necessary to incorporate new methodologies aimed at enhancing the competence of students to use scientific databases.

Resumo Introdução O Modelo de Aceitação Tecnológica (TAM), tem sido bastante utilizado para predizer o uso de bases de dados científicas (BDC). No entanto, é preciso investigar o peso de outras variáveis identificadas na revisão da literatura. Objetivo Identificar os fatores influentes na aceitação e uso das bases de dados científicas por parte dos estudantes da carreira de enfermagem de uma universidade privada. Método O estudo tem um desenho não experimental, transversal de tipo descritivo e correlacional. Aplicou-se um questionário a estudantes da carreira de Enfermagem (Chile). Realizou-se uma análise baseada em regressão de mínimos quadrados parciais em SmartPLS. Resultados Corroboram-se como variáveis preditoras do uso de BDC às variáveis TAM (intenção de uso, utilidade e facilidade de uso) e a outras variáveis externas do modelo (obrigatoriedade, as habilidades informacionais e o treinamento em tecnologias). Discussão A evidência identifica que uma das principais barreiras no uso das BDC são as habilidades informacionais e digitais para sua utilização. Conclusões É necessário incorporar novas metodologias para aumentar a competência dos estudantes com o uso destas bases, para tal efeito consideraram-se as variáveis que resultaram preditoras.

Inusual complicación en la edad pediátrica: encefalopatía de Wernicke asociada a nutrición parenteral deficiente en tiamina / Unusual complication in a paediatric patient: Wernicke encephalopathy associated with thiamine-deficient parenteral nutrition

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Documento de Consenso SEIP-SERPE-SEOP sobre etiopatogenia y diagnóstico de la osteomielitis aguda y artritis séptica no complicadas / SEIP-SERPE-SEOP Consensus Document on aetiopathogenesis and diagnosis of uncomplicated acute osteomyelitis and septic arthritis

Se presenta el Documento de Consenso sobre etiopatogenia y diagnóstico de la osteomielitis aguda y la artritis séptica no complicadas elaborado por la Sociedad Española de Infectología Pediátrica, la Sociedad Española de Reumatología Pediátrica y la Sociedad Española de Ortopedia Pediátrica. En este documento se revisan la etiopatogenia y la fisiopatología de la infección osteoarticular aguda en niños, considerada como aquella no complicada, de origen comunitario, que presenta una evolución inferior a 14 días, así como la aproximación clínico-diagnóstica a estas entidades, basándonos en las mejores evidencias científicas disponibles. En función de dichas evidencias, se aportan una serie de recomendaciones para la práctica clínica

This is a Consensus Document of the Sociedad Española de Infectología Pediátrica, Sociedad Española de Reumatología Pediátrica and Sociedad Española de Ortopedia Pediátrica on the aetiology and diagnosis of uncomplicated acute osteomyelitis and septic arthritis. A review is presented of the aetiopathogenesis and pathophysiology of acute osteoarticular infection defined as a process with less than 14 days of symptomatology, uncomplicated, and community-acquired. The diagnostic approach to these conditions is summarised based on the best available scientific knowledge. Based on this evidence, a number of recommendations for clinical practice are provided

Respuesta a la carta al editor de SEOP en relación con el documento de consenso SEIP-SERPE-SEOP sobre el tratamiento de la osteomielitis aguda y artritis séptica no complicadas / Response to the letter to the editor from SEOP as regards the SEIP-SERPE-SEOP consensus document on the treatment of uncomplicated acute osteomyelitis and septic arthritis

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Documento de consenso SEIP-SERPE-SEOP sobre el tratamiento de la osteomielitis aguda y artritis séptica no complicadas / SEIP-SERPE-SEOP Consensus document on the treatment of uncomplicated acute osteomyelitis and septic arthritis

Presentamos el Documento de Consenso sobre tratamiento de la osteomielitis aguda y la artritis séptica no complicadas, elaborado por la Sociedad Española de Infectología Pediátrica, la Sociedad Española de Reumatología Pediátrica y la Sociedad Española de Ortopedia Pediátrica. En este documento se revisa el abordaje y el tratamiento médico-quirúrgico de la infección osteoarticular aguda, considerada como aquella que presenta una evolución inferior a 14 días, no complicada, de origen comunitario en niños, basándonos en las mejores evidencias científicas disponibles y valorando las diversas opciones disponibles en la actualidad. En función de dichas evidencias, se aportan una serie de recomendaciones para la práctica clínica

This is a Consensus Document of the Spanish Society of Paediatric Infectious Diseases (Sociedad Española de Infectología Pediatrica), Spanish Society of Paediatric Rheumatology (Sociedad Española de Reumatología Pediátrica) and the Spanish Society of Paediatric Orthopaedics (Sociedad Española de Ortopedia Pediátrica), on the treatment of uncomplicated acute osteomyelitis and septic arthritis. A review is presented on the medical and surgical treatment of acute osteoarticular infection, defined as a process with less than 14 days of symptomatology, uncomplicated and community-acquired. The different possible options are evaluated based on the best available scientific knowledge, and a number of evidence-based recommendations for clinical practice are provided

Recurrent infective endocarditis due to Aggregatibacter aphrophilus and Staphylococcus lugdunensis.

Uncommon microorganisms are increasingly being recognized as causative agents of paediatric infectious endocarditis (IE). We report a 4-year old girl with congenital heart disease, who suffered from 2 IE episodes secondary to Aggregatibacter aphrophilus (formerly Haemophilus aphrophilus) and Staphylococcus lugdunensis, both rarely reported pathogens in this age group. The patient was initially successfully treated with prolonged intravenous antibiotic courses, however removal of the Contegra valved conduit during the second episode was required due to recurrence of fever and development of pulmonary embolism despite completion of antibiotic therapy. A. aphrohilus is a member of the fastidious gram negative microorganisms of the HACEK group (Haemophilus spp., Aggregatibacter spp, Cardiobaterium hominis, Eikenella corrodens and Kingella kingae), that colonize the oropharynx and are a recognised cause of IE. Prognosis of children with IE due to HACEK group members varies, half of them suffering from complications and mortality rates of 10-12.5%. Although S. lugdunensis belongs to coagulase negative staphylococci (CONS), it behaves more like S. aureus species rather than CONS. This microorganism is a well-described cause of endocarditis in adult patients, associated with high requirements of surgical procedures and mortality (42-78%). In conclusion, paediatric IE can be caused by uncommon microorganisms associated with severe complications and potential fatality. The isolation of S. lugdunensis or A. aphrophilus in febrile patients should be considered clinically relevant and cardiac involvement must be ruled out. Those patients with proved IE will require prolonged intravenous antibiotic courses and in complicated cases surgical intervention.

[SEIP-SERPE-SEOP Consensus document on the treatment of uncomplicated acute osteomyelitis and septic arthritis]. / Documento de consenso SEIP-SERPE-SEOP sobre el tratamiento de la osteomielitis aguda y artritis séptica no complicadas.

This is a Consensus Document of the Spanish Society of Paediatric Infectious Diseases (Sociedad Española de Infectología Pediatrica), Spanish Society of Paediatric Rheumatology (Sociedad Española de Reumatología Pediátrica) and the Spanish Society of Paediatric Orthopaedics (Sociedad Española de Ortopedia Pediátrica), on the treatment of uncomplicated acute osteomyelitis and septic arthritis. A review is presented on the medical and surgical treatment of acute osteoarticular infection, defined as a process with less than 14 days of symptomatology, uncomplicated and community-acquired. The different possible options are evaluated based on the best available scientific knowledge, and a number of evidence-based recommendations for clinical practice are provided.

[SEIP-SERPE-SEOP Consensus Document on aetiopathogenesis and diagnosis of uncomplicated acute osteomyelitis and septic arthritis]. / Documento de Consenso SEIP-SERPE-SEOP sobre etiopatogenia y diagnóstico de la osteomielitis aguda y artritis séptica no complicadas.

This is a Consensus Document of the Sociedad Española de Infectología Pediátrica, Sociedad Española de Reumatología Pediátrica and Sociedad Española de Ortopedia Pediátrica on the aetiology and diagnosis of uncomplicated acute osteomyelitis and septic arthritis. A review is presented of the aetiopathogenesis and pathophysiology of acute osteoarticular infection defined as a process with less than 14 days of symptomatology, uncomplicated, and community-acquired. The diagnostic approach to these conditions is summarised based on the best available scientific knowledge. Based on this evidence, a number of recommendations for clinical practice are provided.

Infección neumocócica en Pediatría. De la clínica al laboratorio / Pediatric pneumococcal infection. From clinics to laboratory

Streptococcus pneumoniae es uno de los patógenos de mayor relevancia en las enfermedades infecciosas. En estos últimos años hemos desarrollado en el Hospital Virgen del Rocío una línea de investigación sobre la infección neumocócica en Pediatría con un abordaje integral y multidisciplinario. LA introducción de técnicas de serotipación y genotipación molecular en muestras clínicas nos permitió analizar los factores asociados al incremento de la incidencia del empiema pleural pediátrico, que se relacionó con una onda epidérmica por expansión de la clona ST306 del serotipo 1 neumocócico. En un estudio de portadores nasofaríngeos se observaron incrementos significativos de lo largo del tiempo de los serotipos 15B/C y 19ª, que se siguieron con el adloramiento de este último serotipo como causa importante de enfermedad invasora neumocócica en nuestro medio. Finalmente, hemos establecido una línea de colaboración con grupos de investigación básica para el desarrollo de una metodología experimental basada en una combinación de estrategias proteómicas con el objetivo de descubrir nuevos candidatos proteicos para el desarrollo de vacunas y plataformas diagnósticas frente a la infección por S. pneumoniae (AU)

Streptococcus pneumoniae is one of the most important pathogens in infectious diseases. We have been conducting several research projects on pneumococcal infection in children at the University Hospital Virgen del Rocío during recent years and they were based on a multidisciplinary and comprehensive approach. The introduction of molecular techniques allowed to identify the serotypes and genotypes causing pediatric pleural empyema (PPE) and relate these data to disease increasing incidence. This was partly due to clonal expansion of the genotype ST306 associated to pneumococcal serotype 1. Significant increases of serotypes 15B/C and 19A were observed over time in nasopharyngeal carriage and they anticipated the emergence of the latter serotype in pneumococcal invasive disease. Finally, we have been collaborating with basic researchers on the development of a methodology based on a combination of proteomic strategies to identify new protein vaccine candidates and to validate diagnostic platforms for prevention and diagnosis of pneumococcal infectionsv (AU)

Sustained high prevalence of pneumococcal serotype 1 in paediatric parapneumonic empyema in southern Spain from 2005 to 2009.

The epidemiology and microbiological characteristics of paediatric parapneumonic empyema (PPE) before the introduction of the new generation of conjugate pneumococcal vaccines (10-valent and 13-valent) are described. All patients <14 years old admitted to a tertiary paediatric hospital with a diagnosis of PPE were prospectively enrolled from January 2005 to December 2009. Pneumococcal serotyping of culture-negative pleural fluid samples was performed using a multiplex real-time PCR assay. Overall, 219 patients had PPE. Incidence rates for PPE remained stable during the study period with a not significant increase in 2009 compared with 2005 (p 0.13), and were temporally associated with higher circulation of pandemic influenza A H1N1 during the last quarter in our population (p 0.001). Pneumococci were detected in 72% of culture-positive and 79% of culture-negative samples. Serotypes were determined in 104 PPE cases. Serotype 1 was the most prevalent serotype identified (42%) followed by serotypes 7F (20%), 3 (16%), 19A (8%) and 5 (7%). Serotype distribution remained similar during all time periods. Pneumococcal serotype 1 remained the most common cause of PPE during the 5-year study. The new generation of pneumococcal conjugate vaccines offers potential serotype coverage of 73% (10-valent) and 99% (13-valent) in the population studied suffering from PPE. Continuous epidemiological and molecular studies are paramount to monitor the impact of pneumococcal vaccines on the epidemiology of PPE.

High prevalence of community-acquired norovirus gastroenteritis among hospitalized children: a prospective study.

Acute gastroenteritis (AGE) causes significant morbidity, especially in young children, and frequently requires hospitalization even in developed countries. Surveillance studies of AGE are important to determine the prevalence and variety of bacterial and viral pathogens, to initiate targeted preventive measures, such as vaccine programmes, and to monitor its impact. A prospective study was conducted in children <5 years old, admitted with AGE between April 2006 and April 2007 to the Virgen del Rocío University Hospital, Seville, Spain. Demographic and clinical data were collected and patients followed-up after hospital discharge. A stool sample from each child was screened for enteropathogenic bacteria and tested by reverse transcription polymerase chain reaction for rotavirus, astrovirus, norovirus and sapovirus and by the immunochromatographic method for enteric adenoviruses. Norovirus was the most common pathogen in hospitalized children, being detected in 27%, followed by rotavirus 21%. Mixed infection occurred in nearly 20% of all norovirus infections and was most commonly associated with Salmonella spp. Rotavirus infection was associated with an overall higher severe clinical score compared with norovirus infection. Lactose intolerance was observed in 29 children (7.5%) and most commonly due to rotavirus infection (p <0.001). Seizures were reported in four children. Norovirus was the commonest cause of AGE in hospitalized children <5 years during 2006-2007 in Seville, Spain. The use of these molecular techniques should be included routinely for the surveillance of sporadic cases and outbreaks of norovirus AGE in children attending hospitals as well as healthcare centres.

Necrotising pneumonia due to influenza A (H1N1) and community-acquired methicillin-resistant Staphylococcus aureus clone USA300: successful management of the first documented paediatric case.

Necrotising pneumonia in young, previously healthy patients due to Panton-Valentine leucocidin (PVL) producing Staphylococcus aureus has been increasingly recognised. PVL pneumonia is often associated with influenza co-infection and high mortality. This case report describes the successful management of the first documented paediatric case of a previous healthy adolescent who developed necrotising pneumonia due to community-acquired methicillin-resistant (CA-MRSA) clone USA300 with pandemic influenza A (H1N1) co-infection, and highlights the importance of early recognition and initiation of appropriate therapy for this potentially fatal co-infection. PCR remains the gold standard to diagnose pandemic H1N1 since it may not be detected by rapid antigen tests. Bacterial necrotising pneumonia should be suspected in those presenting with worsening flu-like symptoms and clinical and/or radiological evidence of PVL infection (multifocal infiltrates, effusion and cavitation). These patients may benefit from the administration of toxin neutralising agents. In light of the current H1N1 pandemic, healthcare professionals will be increasingly confronted with this clinical scenario.

Modified sequential multiplex PCR for determining capsular serotypes of invasive pneumococci recovered from Seville.

The heptavalent pneumococcal vaccine's introduction resulted in a decline in invasive disease caused by Streptococcus pneumoniae, but was accompanied by an increase in non-vaccine serotypes. We evaluated a modified scheme of the sequential multiplex PCRs adapted to the prevalence of serotypes in Seville (Spain) for determining capsular serotypes of S. pneumoniae invasive clinical isolates. In adults, the modified scheme allowed us to type 73% with the first three reactions, and 92% with two additional PCRs. In paediatric patients, it allowed us to type 73.5% with the first three reactions, and 90% with the two additional PCRs. The multiplex PCR approach was successfully adapted to target the serotypes most prevalent in Seville.

Identification of pneumococcal serotypes from culture-negative clinical specimens by novel real-time PCR.

Pneumococcal parapneumonic empyema is an increasingly common complication in children. Conventional microbiological cultures indicate bacterial causes in as few as 8% of cases; therefore, there is a vital need for new molecular methods of detection and diagnosis. The development and clinical evaluation of real-time PCR-based assays to detect the pneumococcal capsular wzg gene of all serotypes tested are reported here, and 24 of them have been identified in clinical specimens. Using real-time PCR assays with highly specific TaqMan MGB probes that target DNA sequences within the capsular polysaccharide gene cluster, it was possible to differentiate serotypes 1, 3, 5, 4, 6A, 6B, 7F/A, 8, 9V/A/N/L, 14, 15B/C, 18C/B, 19A, 19F/B/C, 23F and 23A. These assays showed high sensitivity (five to ten pneumococcal DNA equivalents) and they were validated with 175 clinical isolates of known serotypes. The clinical value of this approach was demonstrated by analysis of 88 culture-negative pleural fluids from children diagnosed with parapneumonic empyema in three Spanish hospitals. Pneumococcal DNA was detected in 87.5% of pleural fluids, and serotypes 1, 7F and 3 were responsible for 34.3%, 16.4% and 11.9%, respectively, of cases of parapneumonic empyema in children. Such molecular methods are critical for the diagnosis of invasive pneumococcal disease and continued epidemiological surveillance in order to monitor serotype vaccine effectiveness.

Antibiotic susceptibility and molecular epidemiology of nasopharyngeal pneumococci from Spanish children.

Nasopharyngeal pneumococci were collected from 635 Spanish children aged 6 months to 6 years attending four primary healthcare centres (n = 276) or two hospital emergency rooms (n = 359); 36% of the children had received >/=1 dose of pneumococcal conjugate vaccine (PCV7). Overall, the carriage rate of Streptococcus pneumoniae was 31%, with no significant differences in carriage rates according to setting. Colonization with vaccine serotypes was significantly associated with the absence of PCV7 immunization (29.4% vs. 5.9%, p <0.001). Forty-seven per cent of all isolates were penicillin- and/or erythromycin-non-susceptible; 13 international antibiotic-resistant clones were represented among non-susceptible pneumococci and were similarly distributed among vaccine and non-vaccine serotypes.