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We examined literacy related to healthy gestational weight gain (GWG) in immigrant and native Japanese mothers and determined whether it is associated with children’s birth weight.
Longitudinal cohort study.
As the baseline survey in the Japan Environment and Children’s Study (JECS), mothers completed self-administered questionnaires distributed by hand during pregnancy. The self-administered questionnaires used in this study were distributed by mail 6 months after delivery. Children’s birth weight, actual GWG and any complications during delivery were recorded by obstetricians collaborating with JECS.
Of 97 452 mothers who consented to participate in the JECS during pregnancy between January 2011 and March 2014, 67 953 were included in this study after exclusions for multiple births, multiple instances of consent by the same pregnant woman, miscarriages/stillbirths or withdrawal from the study within 3 years after participating. In total, 324 immigrant mothers and 963 native Japanese mothers were selected by propensity score matching for analysis.
Data were collected on maternal literacy related to healthy GWG at the baseline survey, and data on actual GWG and children’s birth weight were collected by obstetricians. The associations of knowledge about healthy GWG and mothers’ actual GWG with maternal nativity status were examined using a 2 or Student’s t-test.
More native Japanese mothers than immigrant mothers knew the appropriate GWG and reason the for needing to know this. Actual GWG was significantly higher among the immigrant mothers, but was within the recommended range. The low birthweight (LBW) incidence was significantly higher among the native mothers.
Immigrant mothers to Japan had less knowledge about appropriate GWG, but their actual GWG was appropriate and they delivered fewer LBW infants than native Japanese mothers. These findings may indicate the presence of other protective factors for pregnancy or delivery among immigrant mothers.
by Lu Wang, Wei Liu, Sitong Bi, Li Zhou, Lihua Li
BackgroundThe roles of minerals in obesity received increasing attention recently due to its oxidant or antioxidant functions and effects on insulin and glucose metabolism that may be associated with obesity. Herein, this study aims to explore the association between minerals and obesity and body mass index (BMI) in children with different ages, and hope to provide some references for prevention and management in children with high-risk of obesity.
MethodsData of children aged 2–17 years old were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2007–2014 in this cross-sectional study. Weighted univariate and multivariate logistic regression and liner regression analyses were used to screen covariates, and explore the association between minerals [including calcium (Ca), phosphorus (P), magnesium (Mg), iron (Fe), zinc (Zn), copper (Cu), sodium (Na), potassium (K) and selenium (Se)] and childhood obesity and BMI. The evaluation indexes were β, odds ratios (ORs) and 95% confidence intervals (CIs). These relationships were also investigated in age subgroups.
ResultsAmong 10,450 eligible children, 1,988 (19.02%) had obesity. After adjusting for covariates, we found the highest quartile of dietary Fe [OR = 0.74, 95%CI: (0.58, 0.95)] and Zn [OR = 0.70, 95%CI: (0.54, 0.92)] intakes were associated with low odds of childhood obesity, while that of dietary Na intake seemed to be positively linked to childhood obesity [OR = 1.35, 95%CI: (1.05, 1.74)]. High dietary intakes of Ca, Na and K were positively associated with children’s BMI, on the contrary, dietary Fe and Zn consumptions had a negative one (all PP Conclusion
Dietary Fe and Zn intakes played positive roles in reducing childhood obesity or BMI, while the intakes of Na should be controlled suitably.
by Naokata Kutsuzawa, Yoko Ito, Shizuko Kagawa, Chinatsu Kohno, Hiroto Takiguchi, Koichiro Asano
Alveolar barrier dysfunction is one of the major pathophysiological changes in acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). In ALI/ARDS, tumor necrosis factor-alpha (TNFα) disrupts the barriers of alveolar epithelium and endothelium. Glucocorticoids (GCs) exert anti-inflammatory effects and ameliorate pulmonary edema in ALI/ARDS. However, the involvement of GCs in the restoration of alveolar epithelial barrier dysfunction has not been extensively studied. Here, we elucidated that dexamethasone (Dex) restored TNFα-induced alveolar epithelial barrier dysfunction in vitro using primary rat alveolar epithelial cells isolated from Sprague–Dawley rats. Moreover, Dex promoted the alveolar epithelial cell barrier integrity by initiating GC receptor-mediated signaling via the downregulation of myosin light chain kinase (MLCK) expression and the dephosphorylation of myosin light chain (MLC) 2. Further investigation revealed that Dex enhanced the expression of zonula occludens-1 (ZO-1), a tight junction-related protein, at intercellular junction sites. These findings suggest that GCs strengthen the integrity of the alveolar epithelial barrier in ALI/ARDS via the GR-MLCK-pMLC2 axis.by Adib Miraki Feriz, Fatemeh Bahraini, Arezou Khosrojerdi, Setareh Azarkar, Seyed Mehdi Sajjadi, Edris HosseiniGol, Mohammad Amin Honardoost, Samira Saghafi, Nicola Silvestris, Patrizia Leone, Hossein Safarpour, Vito Racanelli
Immunotherapy is changing the Head and Neck Squamous Cell Carcinoma (HNSCC) landscape and improving outcomes for patients with recurrent or metastatic HNSCC. A deeper understanding of the tumor microenvironment (TME) is required in light of the limitations of patients’ responses to immunotherapy. Here, we aimed to examine how Nivolumab affects infiltrating Tregs in the HNSCC TME. We used single-cell RNA sequencing data from eight tissues isolated from four HNSCC donors before and after Nivolumab treatment. Interestingly, the study found that Treg counts and suppressive activity increased following Nivolumab therapy. We also discovered that changes in the CD44-SSP1 axis, NKG2C/D-HLA-E axis, and KRAS signaling may have contributed to the increase in Treg numbers. Furthermore, our study suggests that decreasing the activity of the KRAS and Notch signaling pathways, and increasing FOXP3, CTLA-4, LAG-3, and GZMA expression, may be mechanisms that enhance the killing and suppressive capacity of Tregs. Additionally, the result of pseudo-temporal analysis of the HNSCC TME indicated that after Nivolumab therapy, the expression of certain inhibitory immune checkpoints including TIGIT, ENTPD1, and CD276 and LY9, were decreased in Tregs, while LAG-3 showed an increased expression level. The study also found that Tregs had a dense communication network with cluster two, and that certain ligand-receptor pairs, including SPP1/CD44, HLA-E/KLRC2, HLA-E/KLRK1, ANXA1/FPR3, and CXCL9/FCGR2A, had notable changes after the therapy. These changes in gene expression and cell interactions may have implications for the role of Tregs in the TME and in response to Nivolumab therapy.To investigate whether a low Braden Skin Score (BSS), reflecting an increased risk of pressure injury, could predict the risk of delirium in older patients in the intensive care unit (ICU).
Delirium, a common acute encephalopathy syndrome in older ICU patients, is associated with prolonged hospital stay, long-term cognitive impairment and increased mortality. However, few studies have explored the relationship between BSS and delirium.
Multicenter cohort study.
The study included 24,123 older adults from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and 1090 older adults from the eICU Collaborative Research Database (eICU-CRD), all of whom had a record of BSS on admission to the ICU. We used structured query language to extract relevant data from the electronic health records. Delirium, the primary outcome, was primarily diagnosed by the Confusion Assessment Method for the ICU or the Intensive Care Delirium Screening Checklist. Logistic regression models were used to validate the association between BSS and outcome. A STROBE checklist was the reporting guide for this study.
The median age within the MIMIC-IV and eICU-CRD databases was approximately 77 and 75 years, respectively, with 11,195 (46.4%) and 524 (48.1%) being female. The median BSS at enrollment in both databases was 15 (interquartile range: 13, 17). Multivariate logistic regression showed a negative association between BSS on ICU admission and the prevalence of delirium. Similar patterns were found in the eICU-CRD database.
This study found a significant negative relationship between ICU admission BSS and the prevalence of delirium in older patients.
The BSS, which is simple and accessible, may reflect the health and frailty of older patients. It is recommended that BSS assessment be included as an essential component of delirium management strategies for older patients in the ICU.
This is a retrospective cohort study, and no patients or the public were involved in the design and conduct of the study.
To determine the socio-demographic profile of all students enrolled to study medicine in Aotearoa New Zealand (NZ).
Observational, cross-sectional study. Data were sought from the Universities of Auckland and Otago, the two NZ tertiary education institutions providing medical education, for the period 2016–2020 inclusive. These data are a subset of the larger project ‘Mirror on Society’ examining all regulated health professional enrolled students in NZ. Variables of interest: gender, citizenship, ethnicity, rural classification, socioeconomic deprivation, school type and school socioeconomic scores. NZ denominator population data (18–29 years) were sourced from the 2018 census.
2858 students were enrolled to study medicine between 2016 and 2020 inclusive.
There were more women (59.1%) enrolled to study medicine than men (40.9%) and the majority (96.5%) were in the 18–29 years age range. Māori students (rate ratio 0.92; 95% CI 0.84 to 1.0) and Pacific students (rate ratio 0.85; 95% CI 0.73 to 0.98) had lower overall rates of enrolment. For all ethnic groups, irrespective of rural or urban origin, enrolment rates had a nearly log-linear negative relationship with increasing socioeconomic deprivation. Enrolments were lower for students from rural areas compared with those from urban areas (rate ratio 0.53; 95% CI 0.46–0.61). Overall NZ’s medical students do not reflect the diverse communities they will serve, with under-representation of Māori and Pacific students and students who come from low socioeconomic and rural backgrounds.
To meaningfully address these issues, we suggest the following policy changes: universities commit and act to Indigenise institutional ways of knowing and being; selection policies are reviewed to ensure that communities in greatest need of doctors are prioritised for enrolment into medicine (specifically, the impact of low socioeconomic status should be factored into selection decisions); and the government fund more New Zealanders to study medicine.
To understand the experiences of advanced practice nurses working in cancer care.
Phenomenological qualitative study.
Three focus groups were held to collect qualitative data. Participants were recruited through theoretical non-probabilistic sampling of maximum variation, based on 12 profiles. Data saturation was achieved with a final sample of 21 oncology advanced practice nurses who were performing advanced clinical practice roles in the four centers from December 2021 to March 2022. An interpretative phenomenological analysis was performed following Guba and Lincoln's criteria of trustworthiness. The centers' ethics committee approved the study, and all participants gave written informed consent. Data analysis was undertaken with NVivo 12 software.
Three broad themes emerged from the data analysis: the role performed, facilitators and barriers in the development of the role and nurses' lived experience of the role.
Advanced practice nurses are aware that they do not perform their role to its full potential, and they describe different facilitators and barriers. Despite the difficulties, they present a positive attitude as well as a capacity for leadership, which has allowed them to consolidate the advanced practice nursing role in unfavourable environments.
These results will enable institutions to establish strategies at different levels in the implementation and development of advanced practice nursing roles.
Reporting complied with COREQ criteria for qualitative research.
No patient or public contribution.
To estimate the effects of nurse-led self-care interventions on people with heart failure (HF).
Research evidence of the effects of nurse-led HF self-care interventions on patient outcomes is scant.
A systematic review and meta-analysis of randomised controlled trials (RCTs).
Six databases (MEDLINE, Embase, Web of Science, CENTRAL, CINAHL and PsycINFO) were searched from the inception to December 2022 to identify eligible studies.
RCTs published in English that evaluated the impact of nurse-led HF self-care interventions on quality of life, anxiety, symptom burden, sleep quality, healthcare service utilisation and mortality were included. The risk of bias in included studies was assessed using RoB 2.0. We conducted data syntheses using the R software and graded the quality of the evidence using the GRADE approach. The systematic review was conducted in accordance with the PRISMA.
Twenty-five studies with 2746 subjects were included. Our findings demonstrated, that compared to the controls, nurse-led self-care interventions improved QOL (SMD: .83, 95% CI: .50–1.15, moderate evidence), anxiety (MD: 1.39, 95% CI: .49–2.29, high evidence) and symptom burden (SMD: .81, 95% CI: .24–1.38, low evidence) in people with HF. No significant effects were found in all-cause hospital readmission and all-cause emergency department visit. Research evidence on sleep quality, cardiac-related hospital readmission, cardiac-related emergency department visit and all-cause mortality remained unclear.
Our review suggests that nurse-led HF self-care interventions have favourable effects on the QOL, anxiety and symptom burden. Further, well-designed RCTs are warranted to address the gaps identified in this review.
The results indicated that nurse-led HF self-care interventions could improve QOL, anxiety and symptom burden in people with HF. Nurse-led self-care intervention could be integrated into current HF management practices.
by Madoka Tonosaki, Akira Fujimori, Takeshi Yaoi, Kyoko Itoh
Abnormal spindle-like microcephaly associated (ASPM) is a causative gene of primary autosomal recessive microcephaly. Microcephaly is considered to be a consequence of a small brain, but the associated molecular mechanisms are not fully understood. In this study, we generated brain-specific Aspm knockout mice to evaluate the fetal brain phenotype and observed cortical reduction in the late stage of murine cortical development. It has been reported that the total number of neurons is regulated by the number of neural stem and progenitor cells. In the Aspm knockout mice, no apparent change was shown in the neural progenitor cell proliferation and there was no obvious effect on the number of newly generated neurons in the developing cortex. On the other hand, the knockout mice showed a constant increase in apoptosis in the cerebral cortex from the early through the late stages of cortical development. Furthermore, apoptosis occurred in the neural progenitor cells associated with DNA damage. Overall, these results suggest that apoptosis of the neural progenitor cells is involved in the thinning of the mouse cerebral cortex, due to the loss of the Aspm gene in neocortical development.by Ana Carolina Cavalcante Rodrigues, Caroline Vitória de Lima Moreira, Camila Carlos Prado, Luan Silvestro Bianchini Silva, Rafael Fernandes Costa, Adesina Paul Arikawe, Gustavo Rodrigues Pedrino, Elson Alves Costa, Osmar Nascimento Silva, Hamilton Barbosa Napolitano, Iranse Oliveira-Silva, James Oluwagbamigbe Fajemiroye
Profiling the variability related to the estrous cycle is essential for assessing depressive-like behavior and screening drugs. This study compares circulating plasma corticosterone levels [CORT] and behavioral alterations in mice exposed to sucrose preference, forced swimming, and tail suspension tests (SPT, FST, and TST, respectively). While SPT exposure did not significantly alter [CORT], FST and TST showed notable changes. Mice in the TST exhibited increased movement and decreased immobility time compared to FST, suggesting a lower likelihood of depressive-like behavior in male mice. Notably, during the proestrus phase, female mice displayed the highest tendency for depressive-like behavior and elevated [CORT], but similar response to antidepressants (imipramine and fluoxetine). The inherent stress of the FST and TST tasks appears to influence [CORT] as well as depressant and antidepressant effects. These comparisons provide valuable insights for further behavioral phenotyping, model sensitivity assessment, and deepen our neurobiological understanding of depression in the context of drug screening.by Sayaka Saito, Kei Mukohara, Kazuhiro Shimomura, Kenta Murotani
BackgroundIn Japan, as elsewhere, physicians meet with and receive gifts from pharmaceutical representatives (PRs). This study aimed to clarify the Japanese public perceptions of physicians’ relationships with PRs, examine the association between these perceptions and their trust in physicians, and compare the public’s and physicians’ awareness, acceptance, and perceptions of the influence of physician-PR relationships.
MethodsA cross-sectional, self-administered, anonymous, internet-panel survey was conducted involving 1,000 participants from the general public. The survey implementation was contracted to Cross Marketing Inc.
ResultsThe mean age of the 1000 participants was 44.8 years (standard deviation 18.3). Forty-eight percent were female. Many of our participants were unaware of certain physician-PR relationships. The public was more acceptable with physicians’ receiving stationery and/or medical textbooks and attending promotional drug seminars at their workplaces compared with receiving meals at restaurants. Many thought that physicians’ involvement in promotional activities influenced their prescribing habits and estimated that the majority of physicians received office stationery and meals from PRs. They were divided as to whether they would like to know about their physicians’ relationships with the industry. Factors associated with higher trust in physicians included participants being 65 years or older, having a primary care physician, being in better health, the belief that physicians’ involvement in promotional activities is acceptable, and their high estimate that physicians are not receiving gifts from PRs. Compared to the physicians, the public had lower awareness of and was more accepting of physicians’ involvement in promotional activities. Meanwhile, the public believed that physician-PR relationships influenced physicians’ prescribing habits more than the physicians themselves.
ConclusionOur survey provided insights into Japanese public perceptions of physician-pharmaceutical industry relationships and their impact on trust in physicians. Physicians should be aware of these perceptions and carefully consider how to foster appropriate relationships with the industry.
Since May 2019, comprehensive genomic profiling (CGP) has been covered by Japan’s health insurance system for patients with solid tumours that have progressed on standard chemotherapy, rare tumours or tumours of unknown primary origin. Although CGP has the potential to identify actionable mutations that can guide the selection of genomically matched therapies for patients with advanced cancer and limited treatment options, less than 10% of patients benefit from CGP testing, which may have a negative impact on patients’ mental status. The aim of this study is to investigate the prevalence of psychological distress and associated factors among patients with advanced cancer who are undergoing CGP testing across Japan.
This multicentre, prospective cohort study will enrol a total of 700 patients with advanced cancer undergoing CGP testing. Participants will be asked to complete questionnaires at three timepoints: at the time of consenting to CGP testing (T1), at the time of receiving the CGP results (T2; 2–3 months after T1) and 4–5 months after T2 (T3). Primary outcome is the prevalence of depression as measured by the Patient Health Questionnaire-9 at the three timepoints. Secondary outcomes are the prevalence of anxiety and Quality of Life Score. Associated factors with psychological distress will also be examined, including knowledge about CGP, attitudes, values and preferences towards CGP, satisfaction with oncologists’ communication and patient characteristics as well as medical information including CGP test results and genomically matched therapies if provided. The prevalence of depression and anxiety will be estimated using the unadjusted raw rates observed in the total sample. Longitudinal changes in measures will be explored by calculating differences between the timepoints. Multivariate associations between variables will be examined using multiple or logistic regression analysis depending on the outcomes to adjust for confounders and to identify outcome predictors.
This study was approved by the Institutional Review Board of the National Cancer Center Japan on 5 January 2023 (ID: 2022-228). Study findings will be disseminated through peer-reviewed journals and conference presentations.
The study is currently recruiting participants and the enrolment period will end on 31 March 2025, with an expected follow-up date of 31 March 2026.
UMIN000049964.
by Kosuke Ishizuka, Taiju Miyagami, Tomoya Tsuchida, Mizue Saita, Yoshiyuki Ohira, Toshio Naito
Prolonged symptoms that occur after COVID-19 (long-COVID) vary from mild, which do not interfere with daily life, to severe, which require long-term social support. This study assessed the secular trend in online searches on long-COVID in Japan. We conducted an observational study using data provided by Yahoo! JAPAN on the monthly search volume of query terms related to long-COVID from January 2020 to December 2022, including the search volume of the query “コロナ後遺症” (long-COVID in Japanese). The number of new cases of COVID-19 by month was used as a control for search trends, and the symptoms retrieved in conjunction with long-COVID were compared. Trends in online searches for each symptom of long-COVID were analyzed. The symptoms of long-COVID were classified according to “Component 1—Symptoms and Complaints” of the International Classification of Primary Care, 2nd edition (ICPC-2). Interest in long-COVID increased in response to peaks in the number of new cases of COVID-19 in Japan. The most frequent symptom searches with long-COVID were hair loss/baldness (3,530, 21,400, and 33,600 searches in 2020, 2021, and 2022, respectively), cough (340, 7,900 and 138,910 searches in 2020, 2021, and 2022, respectively), disturbance of smell/taste (230, 13,340, and 44,160 searches in 2020, 2021, and 2022, respectively), and headache (580, 6,180, and 42,870 searches in 2020, 2021, and 2022, respectively). In addition, the ranking of interest in “weakness/tiredness, general” in long-COVID increased each year (not in the top 10 in 2020, seventh in 2021, and second in 2022), and the absolute number of searches also increased. To our knowledge, this is the first study to investigate secular trends in online interest in long-COVID in the world. Continued monitoring of online interest in long-COVID is necessary to prepare for a possible increase in the number of patients with long-COVID.by Filipa M. Cortez, Catarina L. Nunes, Luís B. Sardinha, Analiza M. Silva, Vítor H. Teixeira
BackgroundAdaptive thermogenesis, defined as the decrease in the energy expenditure components beyond what can be predicted by changes in body mass stores, has been studied as a possible barrier to weight loss and weight maintenance. Intermittent energy restriction (IER), using energy balance refeeds, has been pointed out as a viable strategy to reduce adaptive thermogenesis and improve weight loss efficiency (greater weight loss per unit of energy deficit), as an alternative to a continuous energy restriction (CER). Following a randomized clinical trial design, the BREAK Study aims to compare the effects of IER versus CER on body composition and in adaptive thermogenesis, and understand whether participants will successfully maintain their weight loss after 12 months.
MethodsSeventy-four women with obesity and inactive (20–45 y) will be randomized to 16 weeks of CER or IER (8x2 weeks of energy restriction interspersed with 7x1 week in energy balance). Both groups will start with 2 weeks in energy balance before energy restriction, followed by 16 weeks in energy restriction, then 8 weeks in energy balance and finally a 12-month weight maintenance phase. Primary outcomes are changes in fat-mass and adaptive thermogenesis after weight loss and weight maintenance. Secondary outcomes include weight loss, fat-free mass preservation, alterations in energy expenditure components, and changes in hormones (thyroid function, insulin, leptin, and cortisol).
DiscussionWe anticipate that The BREAK Study will allow us to better understand adaptive thermogenesis during weight loss and weight maintenance, in women with obesity. These findings will enable evidence-based decisions for obesity treatment.
Trial registrationClinicalTrials.gov: NCT05184361.
Objetivo: Evaluar la efectividad de un instrumento interdisciplinario, desarrollado y aplicado en una unidad de cuidados intensivos de adultos para reducir las infecciones asociadas a la atención de la salud. Metodología: Estudio transversal, cuantitativo, realizado de enero de 2018 y junio de 2019, en una UCI de un Hospital de Paraná-Brasil. Resultados: Se evaluaron 759 pacientes. Antes de la aplicación del instrumento, las medias eran respectivamente: 1,00 para IRAS CVC; 6.78 ID IPCS; 3,22 VAP; 21,62 DIPAV y 0,88 para IRAS CVD, después con la aplicación del Fast Checklist: 0,11 para IRAS CVC (p = 0,11); 0,86 ID IPCS (p = 0,017); 0,33 VAP (p = 0,001); 2,83 DIPAV (p = 0,003) y 0,00 para IRAS ECV (p = 0,0002). Conclusión principal: El estudio demostró que la implementación y aplicación diaria de la Lista de Verificación Rápida fue efectiva para la reducción de las IRAS en la Unidad de Cuidados Intensivos.
Objetivo: Analizar las repercusiones de la pandemia por el nuevo coronavirus en la salud de los profesionales de enfermería. Método: Investigación cuantitativa, descriptiva, realizada en un hospital universitario de Salvador, Bahía, Brasil, entre septiembre y octubre de 2020. La recolección de datos se realizó a través de un cuestionario electrónico estructurado, que fue respondido por 209 profesionales de enfermería de la institución. El proyecto fue aprobado por un Comité de Ética en Investigación (nº CAAE 36841720.0.0000.0049). Resultados: La mayoría de los profesionales relató insomnio o dormir menos de lo necesario (62,67%); mostró aumento del deseo de comer (46,89%) o pérdida del apetito (16,75%); tuvo pérdidas en actividades de ocio (97,6%); relataron una disminución en la práctica de actividad física (91,87%); mostró alteraciones en el estado de ánimo (83,75%); reportó algún grado de ansiedad (89,95%); y tenía diagnóstico de covid-19 (28,23%). Conclusión: Los resultados indican las repercusiones que trajo la pandemia para la salud física y mental de los profesionales de enfermería.
Introducción: El asma, enfermedad crónica infantil más frecuente, está aumentando probablemente en relación a la exposición a factores ambientales. Estos están asociados a la aparición de asma y como desencadenante de síntomas. La literatura al respecto es controvertida. El objetivo de este trabajo es comprobar la posible influencia de la exposición a animales y/o humo de tabaco en el domicilio sobre el grado de control de la enfermedad y el número de exacerbaciones en población pediátrica asmática. Metodología: Estudio observacional realizado en población pediátrica que acudía a consulta de Neumología Pediátrica del hospital de referencia diagnosticados de asma y que tuviera pautado tratamiento inhalado. Como variable dependiente se consideró el número de exacerbaciones y como variables independientes se incluyeron sociodemográficas, variables asociadas a factores ambientales, así como a la técnica de inhalación. Resultados: Participaron 204 familias (66,7% niños). El 70,6% no tenían animales y el 78% no eran fumadores. La media de las exacerbaciones durante el periodo a estudio fue de 1,62. Un 84,8% de los/las pacientes presentan un buen control de la enfermedad. Discusión: Se encuentra relación entre el tener o no animales en casa y/o estar expuestos al tabaco y el grado de control de la enfermedad y número de exacerbaciones, confirmando lo descrito por varios autores. Es importante realizar una intervención individual donde se evalúen los factores que afectan a niños asmáticos y tratar los que sean modificables: manejo guiado de síntomas y tratamiento de exacerbaciones, consejo antitabaco, fomento actividad física… para mejorar su calidad de vida.
ABSTRACT
Introduction: Asthma, the most common chronic disease in childhood, is probably increasing in relation to exposure to environmental factors. These are associated with the onset of asthma and as a trigger for symptoms. The evidence on this is controversial. The objective of this study is to verify the possible influence of exposure to animals and/or tobacco smoke at home on the degree of control of the disease and the number of exacerbations in the paediatric asthmatic population. Methodology: Observational study carried out in a paediatric population that were attended at the paediatric pulmonology consultation of the reference hospital diagnosed with asthma and who had scheduled inhaled treatment. The number of exacerbations was considered as a dependent variable, and sociodemographic variables, variables associated with environmental factors, as well as the inhalation technique were included as independent variables. Results: 204 families participated (66,7% boys). 70,6% did no have animals and 78% were not smokers. The mean number of exacerbations during the study period was 1,62. 84,4% of the patients have good control of the disease. Discussion: A relationship was found between having or not having animals at home and/or being exposed to tobacco smoke and the degree of control of the disease and the number of exacerbations, confirming what has been described by several authors. It is important to carry out an individual intervention where the factors that affect asthmatic children are evaluated and treat those that are modifiable: guided management of symptoms and treatment of exacerbations, anti-smoking advice, physical activity promotion … to improve their quality of life.
Caso: ejemplo mujer de 52 años de edad, que vive en zona rural que, a raíz de la realización de una estoma digestivo definitivo, manifiesta rechazo afectivo-sexual. Objetivo: identificar intervenciones basadas en evidencias destinadas restablecer la vida sexual en la persona ostomizada, garantizando su seguridad, aceptación de su nueva realidad corporal y motivación hacia la práctica erótica. Metodología: búsqueda de evidencias siguiendo el modelo PRAXIS. Recomendaciones de buena práctica: (a) Orientar al paciente ostomizado en todos aquellos aspectos relacionados con su estoma para recuperar la autosuficiencia, (b) Ayudar a la persona ostomizada a mejorar su imagen corporal durante el contacto sexual, (c) Implementar aquellas estrategias que la ayuden a retomar la práctica erótica- sexual, (d) Trabajar con su entorno familiar las habilidades positivas de comunicación para favorecer la aceptación de su nueva realidad corporal, (e) Estimular el contacto y visitas con personas que ha pasado por idéntica experiencia. Prácticas de autocuidado: apoyo profesional, compartir temores y experiencia con entorno social y grupos de apoyo, superar la vergüenza, actitud positiva.
Objetivo principal: Evaluar el manejo del inhalador presurizado de dosis media en el paciente pediátrico. Metodología: Estudio exploratorio transversal y evaluativo a través de un cuestionario con preguntas cerradas. Se creó un índice (Ic; escala de 0 a 1) para valorar el uso correcto de los inhaladores. Resultados principales: La puntuación media obtenida del uso correcto fue de Ic=0,64 (d.e. +/- 0,176). Aun-que este índice es superior en los casos en los que se declara haber recibido una explicación (Ic=0,65) con relación a los que indican que no (Ic=0,53), no se encontró significación estadística entre dicha diferencia (p=0,331). Asimismo, se apreció que cuando es el personal de enfermería es quién realiza la explicación el índice es mayor comparado con otros profesionales (Ic=0,7; p=0,23). Conclusión principal: No se encontró ningún niño que no cometiera al menos un error. Observamos un índice de uso correcto más elevado cuando la explicación parte de enfermería.
Los tumores de células germinativas del ovario constituyen un grupo de tumores de rara presentación, malignos y de rápida evolución, que suelen aparecer en mujeres jóvenes, siendo el disgerminoma un tipo de ellos. El disgerminoma requiere cirugía y biopsia, pues al no secretar hormonas no tiende a causar elevación de los marcadores séricos. Su silente y rápida evolución, muchas veces dificulta su precoz diagnóstico y tratamiento adecuado. El objetivo del presente trabajo ha sido realizar un proceso de atención de enfermería en una paciente diagnosticada con disgerminoma. Se ha llevado a cabo una búsqueda bibliográfica sobre el disgerminoma en diferentes bases de datos y páginas web. En conclusión, se busca aportar unos cuidados enfermeros individualizados de mayor calidad a la pa-ciente y un mayor conocimiento de la enfermedad por parte del profesional de enfermería.
FreshRSS 