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Ayer — Octubre 2nd 2025Tus fuentes RSS

New regimens of benznidazole for the treatment of chronic Chagas disease in adult participants in indeterminate form or with mild cardiac progression (NuestroBen study): protocol for a phase III randomised, multicentre non-inferiority clinical trial

Por: Marques · T. · Forsyth · C. · Barreira · F. · Lombas · C. · Blum de Oliveira · B. · Laserna · M. · Molina · I. · Bangher · M. d. C. · Javier Fernandez · R. · Lloveras · S. · Fernandez · M. L. · Scapellato · P. · Patterson · P. · Garcia · W. · Ortiz · L. · Schijman · A. · Moreira · O. C.
Introduction

Chagas disease (CD) is one of the most neglected diseases in the world. In Latin America, CD is endemic in 21 countries, with an estimated 70 million people at risk of infection. Current treatments are limited to two nitroheterocyclic compounds: nifurtimox and benznidazole (BZN). Each has significant limitations, including long duration and safety concerns. However, data from recently completed studies suggest that reduced-duration regimens may be equally effective while enhancing safety.

Methods and analysis

NuestroBen is a phase III, randomised, multicentre clinical trial designed to assess whether shorter (2- and 4-week) regimens of BZN are non-inferior to the standard 8-week treatment. A total of 540 adult participants with no evidence of organ damage (the indeterminate form) or with mild cardiac progression (mild electrocardiographic alterations and without systolic dysfunction or symptoms), all in the chronic phase of CD, will be recruited at six study sites in Argentina and two study sites in Bolivia. Participants will be randomised to receive one of the two shortened regimens of BZN (300 mg per day for 2 or 4 weeks) or standard treatment (300 mg per day for 8 weeks). The primary endpoint is sustained elimination of parasitaemia from the end of treatment through 12 months of follow-up. Secondary endpoints will assess sustained clearance of parasitaemia at 1, 4, 6 and 8 months of follow-up from the end of treatment, drug tolerability and adherence to treatment. NuestroBen will also evaluate whether two shortened regimens of BZN improve drug tolerability and treatment adherence compared with the current standard treatment while maintaining efficacy in participants with the indeterminate form of CD or with mild cardiac involvement.

Ethics and dissemination

In Argentina, this study was approved by Fundación de Estudios Farmacológicos y Medicamentos ‘Luis M. Zieher’ for its conduct at the Instituto de Cardiología de Corrientes ‘Juana Francisca Cabral’ (reference: NuestroBen-2020/2021) and the Instituto Nacional de Parasitología ‘Dr. Mario Fatala Chaben’ (reference: NuestroBen-2020/2021) by Comité Institucional de Ética de Investigación en Salud for the Centro de Chagas y Patología Regional de Santiago del Estero (reference: NuestroBen-2020-088/2021), by Comité de Ética en Investigación for the Hospital de Infecciosas F.J. Muñiz (reference: NuestroBen-2020–4037) and the Hospital General de Agudos D.F. Santojanni (reference: NuestroBen-2020–4039) and by Comité de Bioética for the Fundación Huésped (reference: NuestroBen-2020/2021). In Bolivia, it was approved by Comité de Ética en Investigación en Salud from the Universidad Autónoma Juan Misael Saracho (reference: NuestroBen-2020/2025). All participants are asked to provide written informed consent to participate. Recruitment processes started in July 2023, and as of 15 June 2025, 140 participants have been recruited. Findings will be shared with Argentinian and Bolivian public health officials and with the Chagas and tropical medicine communities via international conferences. Findings will also be published in medical journals.

Trial registration number

NCT04897516.

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Study protocol for the HONIVAH trial: a single-centre randomised study assessing high-flow oxygen therapy versus non-invasive ventilation on lung volumes and the upper airway in hypoxemic critically ill patients

Por: Monet · C. · Piron · L. · Pressac · M. · Molinari · N. · De Jong · A. · Guiu · B. · Jaber · S.
Introduction

In non-intubated patients, symptomatic treatment of hypoxaemic respiratory failure is still debated, with different options: (1) standard oxygen therapy (SOT), (2) high-flow nasal cannula oxygen therapy (HFNC) and (3) non-invasive ventilation (NIV). The objective of this study is to compare the effects of HFNC and NIV on lung volumes assessed by CT scan to allow a better understanding of their effectiveness.

Methods and analysis

The HONIVAH study (High-flow Oxygen therapy and Non-Invasive ventilation on lung Volumes and on upper Airway in Hypoxemic critically ill patients) is an investigator-initiated, prospective, single-centre, physiological, randomised, parallel-group, unblinded trial with an electronic system-based randomisation. Patients with hypoxaemic respiratory failure, defined as the need for SOT flow ≥3 L/min to maintain a pulsed oxygen saturation ≥95%, and a CT scan prescribed by the physician in charge of the patient, will be randomly assigned to the HFNC group or the NIV group. Two inspiratory thoracic CT scans will be performed, one with SOT as part of the routine patient management and a second thoracic CT scan with HFNC or NIV, depending on the allocation group. The primary outcome is the comparison of the relative variation in ‘poorly aerated’ and ‘non-aerated’ lung volumes before and after the intervention between the HFNC group and NIV group, assessed by thoracic CT scan. Secondary outcomes included the variation in tracheal cross-sectional upper airway area, lung volumes, gas exchange and patient comfort.

Ethics and dissemination

The study project has been approved by the appropriate ethics committee (Comité de Protection des Personnes Sud-Ouest et Outre-mer 1, France, 2022-A02458-35). Informed consent is required. The results will be submitted for publication in a peer-reviewed journal and presented at one or more scientific conferences.

Trial registration

ClinicalTrials.gov identifier: NCT05643911.

LDL-C achievement in patients with coronary artery disease: a study protocol for the EDHIPO-MARCA retrospective registry

Por: Cordoba-Melo · B. D. · Arango-Ibanez · J. P. · Posso-Marin · S. · Ruiz · A. J. · Molina · D. I. · Gomez-Mesa · J. E.
Introduction

Elevated lipid profiles increase the risk of atherosclerotic cardiovascular disease (ASCVD), a leading cause of mortality worldwide. Despite the availability of lipid-lowering therapy (LLT), adherence to therapy and achievement of Low-Density Lipoprotein Cholesterol (LDL-C) target levels remain suboptimal. Coronary artery disease (CAD) presents substantial public health challenges, with LDL-C goal attainment rates reported to be between 30.0% and 54.0%. The EDHIPO MARCA (Evaluación De adherencia a la terapia HIPOlipemiante en pacientes de Muy Alto Riesgo CArdiovascular) study aims to evaluate LDL-C target achievement among Colombian patients with CAD.

Methods and analysis

This is a retrospective and multicentre study aiming to evaluate LDL-C target achievement within 12 months of coronary angiography across multiple Colombian institutions. Data will be retrospectively extracted from medical records corresponding to the years 2011, 2012, 2016, 2017, 2021 and 2022, which were selected to correspond with the European Society of Cardiology/European Atherosclerosis Society guideline updates. Inclusion criteria included patients ≥18 years old with confirmed CAD and LDL-C reports recorded during outpatient follow-up. The study will evaluate a minimum sample size of 5000 patients, with data collected through medical records and managed using the REDCap platform. Statistical analyses will be conducted to assess LDL-C target achievement, associated factors and temporal trends using mixed-effects models. Uncertainty will also be explored through sensitivity analysis. The EDHIPO MARCA study will provide key insights into LDL-C target achievement in Colombia, contributing to both regional and global CAD management. Its findings will be used to help shape public health policies and serve as a foundation for future prospective research and interventions aimed at mitigating the burden of cardiovascular disease.

Ethics and dissemination

This study was approved by the Comité de Ética en Investigación Biomédica of Fundación Valle del Lili, the coordinating institution and creator of the study protocol. Each participating centre will obtain approval from its local ethics committee prior to data collection. Data will be collected in a de-identified manner, ensuring confidentiality. In accordance with Colombian Resolution 8430, this study is classified as 'no-risk', and informed consent was not required. The findings will be disseminated through scientific events and published in international peer-reviewed journals to contribute to cardiovascular disease management and public health policies.

Flow cytometric lyophilised reagent tube assay for peripheral blood neutrophil myeloperoxidase expression to rule out myelodysplastic neoplasms at a university hospital: a diagnostic accuracy study

Por: Planta · C. · Scheffen · L. · Jacob · M.-C. · Szymanski · G. · Chevalier · S. · Tondeur · S. · Bulabois · B. · Meunier · M. · Lefebvre · C. · Gonnet · N. · Garban · F. · Molina · L. · Paradis · C. · Seigneurin · A. · Chiriac · R. · Merle · R. · Labarere · J. · Park · S. · Raskovalova · T.
Objectives

Although flow cytometric analysis of peripheral blood neutrophil myeloperoxidase expression can accurately rule out myelodysplastic neoplasms (MDS), it lacks reliability and efficiency due to the practical limitations of laboratory-developed liquid reagent-based assays. This study aimed to quantify the agreement and comparative discriminatory accuracy between a single-use flow cytometric lyophilised reagent tube (BD Lyotube Stain 468) and its laboratory-developed liquid reagent counterpart.

Design

Cross-sectional diagnostic accuracy study of two index tests against a reference diagnosis.

Setting

A university hospital in France.

Participants

Consecutive adult patients with an indication for bone marrow aspiration due to suspected MDS and unexplained peripheral blood cytopenia.

Primary outcome

MDS confirmed by cytomorphological evaluation of the bone marrow aspirate performed in duplicate by experienced haematopathologists blinded to the index test.

Results

Of 103 participants enrolled between July 2020 and August 2021, 37 had MDS (prevalence, 36%). The median intra-individual robust coefficient of variation (RCV) for myeloperoxidase expression was 30.9% using the BD Lyotube Stain 468 and 31.2% using the laboratory-developed liquid reagent assay, with an intraclass correlation coefficient of 0.94 (95% CI 0.91 to 0.96). The areas under the receiver operating characteristic curves were 0.83 (95% CI 0.74 to 0.90) and 0.82 (95% CI 0.73 to 0.89), respectively. Using a prespecified threshold of 30.0%, the corresponding sensitivity estimates were 89% (95% CI 75% to 97%) and 95% (95% CI 82% to 99%).

Conclusion

BD Lyotube Stain 468 performs as well as its laboratory-developed liquid reagent counterpart for the quantification of myeloperoxidase expression by peripheral blood neutrophils. It may obviate the need for invasive bone marrow aspiration in up to 40% of patients with suspected MDS.

Trials registration number

NCT04399018.

Vitamin D enhances antiviral responses in dengue virus-infected macrophages by modulating early-response gene expression

by Yordi Sebastián Tamayo-Molina, Juan Felipe Valdés-López, Geysson J. Fernandez, Silvio Urcuqui-Inchima

Dengue virus (DENV), the etiological agent of dengue fever, remains a global health concern, leading to severe illness and death in the absence of any definitive cure. Research has shown that vitamin D may reduce DENV replication in vitro and that dengue patients with low or deficient vitamin D levels are at higher risk of severe dengue. Studies indicate that viral replication is inhibited in human monocyte-derived macrophages (MDM) differentiated in the presence of vitamin D (D3MDM), suggesting that vitamin D may prevent DENV entry into host cells. However, despite these findings, the role of vitamin D in regulating the temporal expression patterns of genes as early, mid, and late transcriptional profile of DENV-infected macrophages remains unclear. Therefore, utilizing a kinetic transcriptomic profile is crucial. This approach provides detailed insights into the dynamic changes in gene expression over time, helping to clarify how vitamin D can modulate the immune response at critical stages of DENV infection. To address the transcriptional dynamics, we conducted a comprehensive analysis of gene expression patterns in MDM and D3MDM infected with Dengue virus serotype 2 (DENV-2). Utilizing bulk RNA sequencing alongside a standard viral growth curve, we systematically analyzed transcriptional kinetics by selecting key time points: 1.5, 3, 5.5, and 10 hours post-infection (h.p.i.) to monitor early viral entry and replication events and 24 h.p.i. to assess gene expression during peak viral particle production. Our temporal analysis revealed a progressive increase in cellular transcripts within the first hour of infection, with a more pronounced gene expression pattern in DENV-2-infected MDM compared to DENV-2-infected D3MDM at this early stage. Enrichment analysis indicated a reduced inflammatory response in DENV-2-infected D3MDM. Additionally, transcription factor analysis suggested diminished NF-κB signaling, but enhanced IRF5 activity was elevated in the DENV-2-infected D3MDM. High-dimensional clustering analysis identified nine unique gene clusters across both macrophage types, with notable upregulation of genes associated with antiviral activity, including IDO1, ISG20, OASL, IFI44L, RSAD2, IFIT1, MX1, EPSTI1, CXCL10, and CXCL11 in DENV-2-infected D3MDM at 1.5 h.p.i., suggesting an enhanced early antiviral response. These findings indicate that vitamin D modulates the magnitude and diversity of the early transcriptional responses, highlighting its potential as a therapeutic option to mitigate DENV severity.

Predictive Performance of Device‐Neonatal Skin Risk Assessment Scale to Evaluating Pressure Injuries Risk in the Neonates. An Observational Multicenter Study

ABSTRACT

Aim

To assess the validity of a modified Neonatal Skin Risk Assessment scale (Dev-NSARS) for neonatal pressure injuries (PIs) in the neonatal intensive care unit (NICU) and neonatal sub-intensive care unit (NICU-Sub) environment.

Background

Medical devices are the leading cause of pressure injuries (PIs) in neonates, a key cause of morbidity in neonatology, significantly impacting the length of stay (LOS) and public hospital resources.

Methods

The Dev-NSRAS scale, considering the presence of medical devices, was tested on a national multicenter prospective study on newborns. The discrimination power of the Dev-NSRAS scale was compared to that of the more commonly used Glamorgan scale.

Results

Nine newborns (6.6%) developed PIs, with a total of 16 injuries, 75% (12 out of 16) of which were device related. Newborns with postconceptional age ≤ 30.8 weeks were at higher risk of developing PIs. First 24-h total Dev-NSRAS scores were compared with first 24-h Glamorgan scores, to obtain and compare respective sensitivity and specificity. During the first 24 h from admission, a very good discriminative performance was evidenced for Dev-NSRAS ≤ 11 (AUC 0.921, 95% CI: 0.899–0.940, p < 0.0001; 81.6% sensitivity and 93.6% specificity) as compared to a moderate discriminative performance shown by a Glamorgan score > 28 (AUC 0.752, 95% CI: 0.634–0.660, p < 0.0001; 92.1% sensitivity and 65.5% specificity).

Conclusions

Early application (i.e., in the first day from hospital admission) of Dev-NSRAS by the nursing personnel shows excellent accuracy in predicting the risk of developing PUs in newborns admitted to NICU and NICU-Sub, as compared to the Glamorgan scale.

Reporting Method

The STROBE statement for cohort observational studies was used as the reference reporting method.

Impact

The study addressed the lack of a risk assessment scale for pressure injuries in neonates. Development and testing of a scale that demonstrated high sensitivity and specificity in the early prediction of pressure injury risk in neonates within the first 24 h. The research will have an impact in NICUs and NICU-Sub units, enabling nurses to plan personalised care to prevent pressure injuries in neonates, thereby reducing the length of hospital stays and overall healthcare costs.

Contribution

Introduce a validated scale for improving neonatal pressure injury prevention worldwide. Enhance early detection tools, reduce hospital stays and global costs.

Protocol Registration

The study protocol has been approved by the Paediatric Tuscany Region Ethical Committee (date: 18 January 2021; protocol code 18/2021).

Monitoring the Sustainability of a Breastfeeding Guideline During the COVID‐19 Pandemic: A Mixed‐Methods Study

ABSTRACT

Aim

To analyse the impact of the COVID-19 pandemic on the sustainability of a breastfeeding (BF) clinical practice guideline (CPG) for women without COVID-19, throughout the 5 waves of the pandemic.

Desing

A mixed-methods design was utilised.

Methods

For the quantitative approach, an interrupted time series design was utilised, as well as the analysis of CPG sustainability reports as a qualitative approach. The study setting was in a health area in the Spanish health system from April 2019, until October 2021. The sample was composed of 2239 mother–infant dyads.

Results

The exclusive-BF rate at hospital discharge obtained values between 90% and 94.8%, without statistically significant changes. A significant increase in the risk of not starting BF in the first feeding was observed (adjusted odds ratio = 9.36; 95% CI: 1.04–84.13), between the pre-pandemic period and the first wave. Skin-to-skin contact (SSC) decreased in the first wave to 82.20%, and the oscillations observed throughout the pandemic were not statistically significant. In general, the qualitative indicators were maintained. A decrease was observed in the spaces used for postpartum care due to the re-assigning to the intensive care unit. Also, the acquisition of materials and equipment decreased.

Conclusions

The measures implemented for the sustainability of the BF CPG during the 5 waves of the pandemic were positive. The programmes of implementation of BF guidelines were shown to resist the COVID-19 pandemic.

Impact

Our findings contribute to the understanding and evolution of the main indicators of the sustainability of a BF CPG on COVID-19 context, providing details on the magnitude of the effect and the process of change.

Reporting Method

The Preferred Reporting Items for observational studies (STROBE) checklist was followed.

Patient or Public Contribution

No Patient or Public Contribution.

‘Silent Needs and Hidden Desires’: Nurses‘ Perceptions of Sexual Healthcare for People With Physical and/or Intellectual Disabilities

ABSTRACT

Aim and Objectives

To describe nurses' perceptions of sexual healthcare for people with physical and/or intellectual disabilities.

Background

Nurses are responsible for meeting the fundamental needs of people with physical and/or intellectual disabilities, yet there are still issues when it comes to their sexuality. Sexual assistants can help people with physical and/or intellectual disabilities to meet their sexual needs, but little is known about these invisible, unregulated care providers.

Design

Qualitative descriptive study.

Methods

The study was conducted in a region of southern Spain. Convenience sampling was used to recruit 22 nurses aged 23–41 years, who had provided care to people with physical and/or intellectual disabilities. The participants' experiences were explored through semi-structured interviews conducted between November 2022 and May 2023.

Findings

Three main themes were extracted from the data analysis: (1) the need to increase the visibility of people with physical and/or intellectual disabilities sexuality, (2) sexual assistance: a conspiracy of silence and (3) defining the role of sexual assistants.

Conclusion

According to the nurses, sexual assistants are still unregulated care providers who carry out their work in anonymity. Sexual assistants support people with physical and/or intellectual disabilities in the whole spectrum of their sexuality; in addition to sexual pleasure, they provide opportunities for bonding, affection, physical contact, stimulation or caressing. Nurses are committed to normalising the role of sexual assistants and regulating their services within a sound legal framework. Health professionals need to include specific training on sexual assistance in their training programmes.

Relevance to Clinical Practice

Understanding how nurses perceive the sexual needs of people with physical and/or intellectual disabilities, as well as the role of sexual assistants, who could improve this group of people's quality of life by providing them care in different healthcare settings.

No Patient or Public Contribution.

Relationship between social identity and cultural competence among Mexican nursing professionals

Abstract

Introduction

Cultural competence in nursing is crucial for providing effective health care. Social Identity is the degree to which they identify with their professional group. Identifying with the group of nursing professionals allows nurses to connect with norms and values that favor the development of cultural competence. The objective of this study is to analyze the relationship between social identity and the level of cultural competence of nursing professionals.

Methodology

This was a cross-sectional correlational study (n = 211). Sociodemographic data were measured, and Cameron's social identity scales and a cultural competence measurement scale were used. The data were analyzed using correlations and a structural equation model.

Results

The structural equation model demonstrated good fit (CFI = 0.94, TLI = 0.928 WRMR = 0.952, RMSEA = 0.058). The model indicated positive and significant relationships between social identity, cultural skills, and knowledge. However, it also revealed a negative and significant relationship between social identity and cultural awareness.

Conclusions

The findings suggest that greater identification with the nursing profession by nursing professionals is associated not only with higher levels of cultural knowledge and skills but also with lower levels of cultural awareness. This finding may be due to the fact that individuals seek to reinforce their professional identities when they feel that acknowledging their own personal biases represents a threat.

Clinical Relevance

This study contributes to the understanding of how social identity can be related in a different way to the components of cultural competence. This work recognizes the challenges in developing cultural awareness in nursing and suggests that its findings can inform interventions to improve patient care and relationships.

Enhancing blood pressure management protocol implementation in patients with acute intracerebral haemorrhage through a nursing‐led approach: A retrospective cohort study

Abstract

Aim

To evaluate the impact of nurse care changes in implementing a blood pressure management protocol on achieving rapid, intensive and sustained blood pressure reduction in acute intracerebral haemorrhage patients.

Design

Retrospective cohort study of prospectively collected data over 6 years.

Methods

Intracerebral haemorrhage patients within 6 h and systolic blood pressure ≥ 150 mmHg followed a rapid (starting treatment at computed tomography suite with a target achievement goal of ≤60 min), intensive (target systolic blood pressure < 140 mmHg) and sustained (maintaining target stability for 24 h) blood pressure management plan. We differentiated six periods: P1, stroke nurse at computed tomography suite (baseline period); P2, antihypertensive titration by stroke nurse; P3, retraining by neurologists; P4, integration of a stroke advanced practice nurse; P5, after COVID-19 impact; and P6, retraining by stroke advanced practice nurse. Outcomes included first-hour target achievement (primary outcome), tomography-to-treatment and treatment-to-target times, first-hour maximum dose of antihypertensive treatment and 6-h and 24-h systolic blood pressure variability.

Results

Compared to P1, antihypertensive titration by stroke nurses (P2) reduced treatment-to-target time and increased the rate of first-hour target achievement, retraining of stroke nurses by neurologists (P3) maintained a higher rate of first-hour target achievement and the integration of a stroke advanced practice nurse (P4) reduced both 6-h and 24-h systolic blood pressure variability. However, 6-h systolic blood pressure variability increased from P4 to P5 following the impact of the COVID-19 pandemic. Finally, compared to P1, retraining of stroke nurses by stroke advanced practice nurse (P6) reduced tomography-to-treatment time and increased the first-hour maximum dose of antihypertensive treatment.

Conclusion

Changes in nursing care and continuous education can significantly enhance the time metrics and blood pressure outcomes in acute intracerebral haemorrhage patients.

Reporting Method

STROBE guidelines.

Patient and Public Contribution

No Patient or Public Contribution.

Multi‐disciplinary diabetic limb salvage programme in octogenarians with diabetic foot ulcers is not futile: An observational study with historical controls

Abstract

This study evaluated the effectiveness of a multi-disciplinary diabetic limb salvage programme in improving clinical outcomes and optimising healthcare utilisation in 406 patients aged ≥80 years with diabetic foot ulcers (DFUs), compared to 2392 younger patients enrolled from June 2020 to June 2021 and against 1716 historical controls using one-to-one propensity score matching. Results showed that elderly programme patients had lower odds of amputation-free survival (odds ratio: 0.64, 95% CI: 0.47, 0.88) and shorter cumulative length of stay (LOS) compared to younger programme patients (incidence rate ratio: 0.45, 95% CI: 0.29, 0.69). Compared to the matched controls, participating in the programme was associated with 5% higher probability of minor lower extremity amputation, reduced inpatient admissions and emergency visits, shorter LOS but increased specialist and primary care visits (all p-values <0.05). The findings suggest that the programme yielded favourable impacts on the clinical outcomes of patients aged≥80 years with DFUs. Further research is needed to develop specific interventions tailoring to the needs of the elderly population and to determine their effectiveness on patient outcomes while accounting for potential confounding factors.

Perspectivas de enfermería en atención primaria y promoción de salud en los adolescentes durante la pandemia

Sr. Director: A inicios de la pandemia por la enfermedad de coronavi-rus (Covid‑19), producida por el virus SARS-CoV-2, las autoridades en salud emitieron recomendaciones a todos los países a fin de salva-guardar la integridad física de la población [Fragmento de texto].

Percepción de los profesionales sanitarios sobre cómo afecta la luz y ruido al sueño/descanso de los pacientes en el Servicio de Urgencias

Objetivo principal: Mejorar la calidad del sueño y descanso de los pacientes en el servicio de urgencias mediante la participación y cono-cimiento de las percepciones de los profesionales sanitarios. Metodología: Un total de 173 profesionales sanitarios (79 enfermeras/os, 33 TCAE, 29 médicos/as y 32 celadores/as) cumplimentaron el cuestionario ad hoc de percepción de los profesionales sobre cómo afecta la luz y ruido al sueño y descanso de los pacientes. Resultados principales: Aspectos relacionados con la organización y dinámicas de trabajo, las competencias, habilidades y cuidados llevados a cabo por los profesionales daban lugar a distinciones en la participación de responder al cuestionario y en las percepciones de los profesionales sobre cómo la luz y ruido afecta al sueño y descanso de los pacien-tes, lo cual remarcaba la necesidad de evaluar factores perturbadores ambientales y establecer estrategias, medidas, intervenciones y cuidados para mejorar la calidad de sueño de los pacientes. Por tanto, los resultados de este trabajo aportaban nuevos datos en compa-ración con los datos de escasos estudios sobre la necesidad de conocer la percepción de los profesionales sanitarios sobre factores perturbadores ambientales que afectan al sueño/descanso de los pacientes, particularmente en el servicio de urgencias. Conclusión principal: Existe una variabilidad de las diferentes categorías de profesionales sanitarios en relación a la participación en contestar al cuestionario ad hoc, así como diferencias significativas entre las percepciones sobre cómo afecta la luz y ruido sobre el sueño/descanso de los pacientes. Por tanto, se plantean perspectivas de futuro y se alude a estrategias dirigidas a los pacientes, profesionales y organi-zación/entorno de trabajo para mejorar la calidad de sueño de los pacientes en el servicio de urgencias.

Cuidado de enfermería con terapia cognitiva conductual en la depresión postparto

Esta narrativa describe el cuidado que brinda una enfermera matrona, entrenada en terapia cognitivo conductual a una mujer con depresión postparto, con la cual establece una relación terapéutica. Previo consentimiento escrito, se planificaron sesiones terapéuticas basándose en la teoría de Aaron Beck, y durante las mismas, se logró que la puérpera reconociera y plasmara en un papel sus pensam-ientos negativos, reconociera las conexiones entre pensamiento, afecto y conducta, examinara las evidencias que están a favor o en contra de sus pensamientos, corrigiera sus distorsiones, sustituyera los pensamientos negativos por interpretaciones más objetivas y aprendiera a identificar los esquemas condicionantes y los autoesquemas, que predisponen a distorsionar sus experiencias. La capacitación y sensibilidad de la matrona, le permitió atender a la puérpera, y reconocer que más allá de la consulta por mastitis, su demanda inicial, había una depresión, ante la cual debía actuar.

Convivir con el Síndrome del Intestino Irritable

En este relato bibliográfico se cuenta la experiencia de una persona que sufre de la patología crónica del síndrome del intestino irritable, cómo es su afrontamiento desde el primer contacto con ella a cómo ha ido adaptándose progresivamente hasta hacerla partícipe de su vida. El objetivo es abordar cómo se vive con la patología del SII, la experiencia propia de esta persona. También se pretende dar a conocer esta patología, así como presentarla desde la subjetividad de esta persona. Para ello se escoge la metodología cualitativa y se lleva a cabo mediante una entrevista en profundidad y su posterior transcripción a un relato bibliográfico. Se observó que le causó un gran impacto a nivel psicológico pero también se detecta una actitud valerosa y finalmente de aceptación, control hacia la patología.

Intervenciones y cuidados de enfermería en la mejora del sueño/descanso de los pacientes hospitalizados

Introducción: los pacientes en el hospital están expuestos a factores clínicos, ambientales y emocionales que contribuyen a la inquietud, miedo, incertidumbre y a reducir y fragmentar el sueño/descanso. Por ello, una intervención y cuidados de enfermería adecuados por parte de los profesionales de la salud, llevando a cabo medidas específicas para atenuar el impacto del ingreso en el hospital, es funda-mental para mejorar el bienestar y la rápida recuperación de los pacientes. Objetivo: revisar cuales son las intervenciones y cuidados de enfermería más eficaces para mejorar el sueño/descanso. Material y métodos: se llevó a cabo una búsqueda bibliográfica en las princi-pales bases de datos primarias y secundarias como Google Académico®, Pubmed®, CINAHL®, Cochrane® y CUIDEN® de los últimos 10 años, fundamentalmente para conseguir una revisión reciente de la literatura, tanto a nivel nacional como internacional en relación al tema de estudio. El presente trabajo está enfocado como una revisión narrativa descriptiva crítica para aportar datos basados en la evi-dencia. Resultados: se obtuvo un gran número de artículos, de los cuales se seleccionaron los que fueron más relevantes según el obje-tivo de esta revisión narrativa crítica. Discusión y conclusiones: la literatura aporta que unas intervenciones y cuidados de enfermería específicos acordes a la actividad rutinaria en el hospital favorece el sueño/descanso de los pacientes teniendo incidencia en su recupe-ración.

Repercusión de la luz y ruido sobre el sueño/descanso en los pacientes hospitalizados

Introducción: los pacientes que se encuentran hospitalizados sufren un conjunto de reacciones y sentimientos que conlleva generalmente proble-mas de sueño en el hospital, donde el trabajo es continuo en relación a los cuidados que requieren los pacientes y donde es necesario considerar la tecnología que caracteriza a las diferentes unidades, por el ruido que se produce y la luz que requieren los profesionales para llevar a cabo el trabajo. El ruido y la luz son los factores ambientales que afectan en mayor medida a los pacientes hospitalizados. El objetivo es comprobar, identifi-car y discutir cuales son los factores perturbadores ambientales que afectan al sueño/descanso de los pacientes ingresados en el hospital. Material y métodos: se llevó a cabo una búsqueda bibliográfica en las principales bases de datos primarias y secundarias como Pubmed®, CINAHL®, Coch-rane® y Google Acádemico® de los últimos 10 años. Resultados: se obtuvo un gran número de artículos, de los cuales se seleccionaron los que fueron más relevantes según el objetivo de esta revisión narrativa crítica. Discusión y conclusiones: existe una gran complejidad y variabilidad en las metodologías de los diferentes estudios relacionados con factores perturbadores ambientales, pero también en los últimos años se está prestando mayor atención a la investigación sobre los factores que afectan a sueño y descanso de los pacientes ingresados en el hospital. Se puede concluir que el ruido y la luz son los factores perturbadores ambientales principales que afectan al sueño/descanso de los pacientes hospitalizados y que se necesita más investigación de alta calidad para superar las limitaciones y dificultades de estudios previos y fortalecer los cuidados de enfermería basados en la evidencia.

El adecuado producto en el baño preoperatorio

Objetivo principal: Describir que productos son los adecuados para el baño o ducha preoperatoria. Metodología: Se ha realizado una revisión narrativa, a través de la búsqueda en bases de datos electrónicas, que sintetiza la información de los estudios acerca del tema en concreto. Finalmente, tras aplicar criterios de selección y quitar duplicados se obtuvo un total de 12 artículos. Resultados: Se analizaron los estudios considerando que producto (gluconato de clorhexidina al 4%-2%, jabón, povidona yodada o sin producto) se utilizaba para el baño preoperatorio, dado que un correcto abordaje de esta actividad reduce el número de microorganismos de la piel y así minimizar el riesgo de infección de la herida quirúrgica. Conclusión principal: La mayoría de estudios afirman en realizar una ducha preoperatoria, pero hay variedad en el producto a administrar siendo el antiséptico de gluconato de clorhexidina al 4% el más adecuado.

El papel de enfermería en cirugía de colon según el programa de rehabilitación multimodal

Objetivo principal: Describir el programa de rehabilitación multimodal, destacando las actividades en las que participa el profesional de enfermería en el preoperatorio y postoperatorio de cirugía de colon. Metodología: Se ha realizado una revisión narrativa, a través de la búsqueda en bases de datos electrónicas, que sintetiza la información de los estudios acerca del tema en concreto. Finalmente, tras aplicar criterios de selección y quitar duplicados se obtuvo un total de 26 artículos. Resultados: Se analizaron los estudios considerando las etapas prequirúrgicas y postquirúrgicas obteniendo una relación de cuidados de enfermería necesarios para realizar un correcto abordaje al paciente según el programa de rehabilitación multimodal. Conclusión principal: Se ha elaborado un “checklist” basado en los resultados del estudio, para orientar, verificar la cantidad y tipo de cuidados que deben de llevarse a cabo en el programa de rehabilitación multimodal.

WITHDRAWN: Post-traumatic stress disorder-related perinatal factors after the first postpartum year

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