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International trials can be challenging to operationalise due to incompatibilities between country-specific policies and infrastructures. The aim of this systematic review was to identify the operational complexities of conducting international trials and identify potential solutions for overcoming them.
Systematic review.
Medline, Embase and Health Management Information Consortium were searched from 2006 to 30 January 2023.
All studies reporting operational challenges (eg, site selection, trial management, intervention management, data management) of conducting international trials were included.
Search results were independently screened by at least two reviewers and data were extracted into a proforma.
38 studies (35 RCTs, 2 reports and 1 qualitative study) fulfilled the inclusion criteria. The median sample size was 1202 (IQR 332–4056) and median number of sites was 40 (IQR 13–78). 88.6% of studies had an academic sponsor and 80% were funded through government sources. Operational complexities were particularly reported during trial set-up due to lack of harmonisation in regulatory approvals and in relation to sponsorship structure, with associated budgetary impacts. Additional challenges included site selection, staff training, lengthy contract negotiations, site monitoring, communication, trial oversight, recruitment, data management, drug procurement and distribution, pharmacy involvement and biospecimen processing and transport.
International collaborative trials are valuable in cases where recruitment may be difficult, diversifying participation and applicability. However, multiple operational and regulatory challenges are encountered when implementing a trial in multiple countries. Careful planning and communication between trials units and investigators, with an emphasis on establishing adequately resourced cross-border sponsorship structures and regulatory approvals, may help to overcome these barriers and realise the benefits of the approach.
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Introducción: Las enfermedades crónicas no transmisibles van en aumento, ocasionando discapacidad y dependencia en quien la padece, así como la necesidad de un cuidador. La cronicidad es un concepto que se ha analizado desde la mirada de la persona que la padece, dejando un vacío en la comprensión del significado para el cuidador.
Objetivo: comprender el significado de la cronicidad para las personas con Enfermedades crónicas no transmisibles y sus cuidadores informales.
Materiales y métodos: investigación cualitativa fenomenológica-hermenéutica según la propuesta de Van Manen, muestreo casual orientado por criterio, participaron 10 personas enfermas y 9 cuidadores. Los criterios de rigor de credibilidad y confirmabilidad, confiabilidad y la transferibilidad, garantizaron la calidad del estudio.
Resultados: emergieron los siguientes temas: Brindar y recibir cuidado como un acto de amor; unión de la familia; enfrentarse a la dureza; Recibir, brindar y buscar apoyo; Estar pendiente; Cambio de vida; Proceso de aprendizaje; una compañía para toda la vida; Imponer restricciones, limitaciones y pérdidas.
Conclusiones: el significado de la cronicidad para los cuidadores y las personas enfermas es complejo, dinámico y multidimensional; por lo tanto, es necesario realizar intervenciones que ayuden a mitigar el impacto que esta produce en la vida de este binomio.
This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions.
A complementary multi-method study combining survey methods and qualitative interviews will be adopted.
Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a ‘framework analysis’ will be performed.
This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building.
Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts.
Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility.
This qualitative study aimed to explore how young adults experienced the COVID-19 pandemic in relation to extensive lockdowns, social isolation and psychosocial distress. Specifically, this research focused on how the pandemic impacted those who did not contract COVID-19 and lived in a low-risk geographical location. The focus was young adults given they have large social circles (high risk for disease transmission) and have an increased propensity to mental health conditions. These insights can inform planning for future pandemics.
This paper draws on 30 in-depth semistructured interviews. Data were analysed inductively following the principles of a constructivist grounded theory approach.
30 young adults living in Prince Edward Island during the COVID-19 pandemic, a Canadian province with a low number of COVID-19 cases at the time of data collection.
We developed four themes that describe the experience of young adults during the COVID-19 pandemic: (1) life course disruption, (2) fear and anxiety about the COVID-19 virus, (3) isolation and loss of hope and (4) strategies for managing adversity. Our findings highlight the areas of young adults’ lives that were affected by extensive social changes related to the COVID-19 pandemic. We demonstrate that even individuals who had not contracted the virus were considerably impacted.
We provide a detailed description of the comprehensive impact of COVID-19 on low-risk young adults not previously infected with the COVID-19 virus. By reflecting on the biographical disruption experienced by young adults, we highlight the need and opportunity to direct healthcare resources towards identifying and addressing the secondary impacts of pandemics. Consequently, these findings can guide decisions relating to future pandemic restrictions to better account for the experiences of individuals living through them.
by Isabel Matute, Carla Castillo-Laborde
BackgroundAccess to medicines is a serious problem globally and in Chile. Despite the creation of coverage policies, part of the population with chronic conditions of high prevalence, still does not have access to the medicines it requires and disease control continues to be low. The objective of the study was to estimate the medication use and effective coverage for diabetes, dyslipidemia and hypertension in Chile, analyzing them according to sociodemographic variables and social determinants of health.
MethodsCross-sectional analytical study with information from the 2016–2017 National Health Survey (sample = 6,233 people aged 15 years or older, expanded = 14,518,969). Descriptive analyses of medication use and effective coverage for hypertension, diabetes and dyslipidemia were carried out, and multivariate logistic regression models were developed to analyze possible associations with variables of interest.
Results60% of people with hypertension or diabetes use medications and only 27.7% in dyslipidemia. While 54.2% of those with diabetes have their glycemia controlled, in hypertension and dyslipidemia the effective coverage drops to 33.3% and 6.6%, respectively. There are no differences in use by health system, but there are differences in the control of hypertension and diabetes, favoring beneficiaries of the private subsystem. Effective coverage of dyslipidemia and hypertension also increases in those using medications. The drugs coincide with the established protocols, although beneficiaries of the private sector report greater use of innovative drugs.
ConclusionA significant proportion of Chileans with hypertension, diabetes or dyslipidemia still do not use the required medications and do not control their conditions.
To present the psychometric properties of the living with long-term condition (LwLTCs) scale in an English-speaking population of people with different LTCs.
An observational and cross-sectional study, with retest was conducted. Psychometric properties including feasibility, internal consistency, confirmatory factor analysis, reproducibility and content validity were tested.
The study took place across the UK via primary care surgeries and voluntary organisations, between December 2021 and June 2022.
The study included 577 patients living with different LTCs, as chronic obstructive pulmonary disease, arthritis, chronic heart failure, Parkinson’s disease, chronic kidney disease and type 2 diabetes mellitus. Inclusion criteria included: (a) having been diagnosed with one or more of the conditions; (b) being able to read, understand and answer written questionnaires; (c) being fluent in English and (d) being able to provide written informed consent. Patients were involved in the design and pilot study of the scale.
A total sample of 577 people with an age range of 37–97 years (98±9.65) were recruited. Internal consistency of the total 26-item LwLTCs scale score was excellent (ordinal alpha=0.90) but confirmatory factor analysis showed better fit indices (Normed Fit Index=0.96; standardised root mean square residual=0.051; Goodness of Fit Index=0.98) for a 20-item LwLTCs scale.
A shorter version of the LwLTCs scale, with just 20 items and with excellent psychometric properties, is recommended. Having a short scale is key when considering the implementation of the scale in clinical practice to develop person-centred pathways and more comprehensive care plans.
by Raquel Martin-Folgar, Mª Carmen González-Caballero, Mónica Torres-Ruiz, Ana I. Cañas-Portilla, Mercedes de Alba González, Isabel Liste, Mónica Morales
Nanoplastics (NPs) have been found in many ecological environments (aquatic, terrestrial, air). Currently, there is great concern about the exposition and impact on animal health, including humans, because of the effects of ingestion and accumulation of these nanomaterials (NMs) in aquatic organisms and their incorporation into the food chain. NPs´ mechanisms of action on humans are currently unknown. In this study, we evaluated the altered molecular mechanisms on human neural stem cell line (hNS1) after 4 days of exposure to 30 nm polystyrene (PS) NPs (0.5, 2.5 and 10 μg/mL). Our results showed that NPs can induce oxidative stress, cellular stress, DNA damage, alterations in inflammatory response, and apoptosis, which could lead to tissue damage and neurodevelopmental diseases.Chronic wounds contribute to significant healthcare and economic burden worldwide. Wound assessment remains challenging given its complex and dynamic nature. The use of artificial intelligence (AI) and machine learning methods in wound analysis is promising. Explainable modelling can help its integration and acceptance in healthcare systems. We aim to develop an explainable AI model for analysing vascular wound images among an Asian population. Two thousand nine hundred and fifty-seven wound images from a vascular wound image registry from a tertiary institution in Singapore were utilized. The dataset was split into training, validation and test sets. Wound images were classified into four types (neuroischaemic ulcer [NIU], surgical site infections [SSI], venous leg ulcers [VLU], pressure ulcer [PU]), measured with automatic estimation of width, length and depth and segmented into 18 wound and peri-wound features. Data pre-processing was performed using oversampling and augmentation techniques. Convolutional and deep learning models were utilized for model development. The model was evaluated with accuracy, F1 score and receiver operating characteristic (ROC) curves. Explainability methods were used to interpret AI decision reasoning. A web browser application was developed to demonstrate results of the wound AI model with explainability. After development, the model was tested on additional 15 476 unlabelled images to evaluate effectiveness. After the development on the training and validation dataset, the model performance on unseen labelled images in the test set achieved an AUROC of 0.99 for wound classification with mean accuracy of 95.9%. For wound measurements, the model achieved AUROC of 0.97 with mean accuracy of 85.0% for depth classification, and AUROC of 0.92 with mean accuracy of 87.1% for width and length determination. For wound segmentation, an AUROC of 0.95 and mean accuracy of 87.8% was achieved. Testing on unlabelled images, the model confidence score for wound classification was 82.8% with an explainability score of 60.6%. Confidence score was 87.6% for depth classification with 68.0% explainability score, while width and length measurement obtained 93.0% accuracy score with 76.6% explainability. Confidence score for wound segmentation was 83.9%, while explainability was 72.1%. Using explainable AI models, we have developed an algorithm and application for analysis of vascular wound images from an Asian population with accuracy and explainability. With further development, it can be utilized as a clinical decision support system and integrated into existing healthcare electronic systems.
Protein–energy malnutrition and the subsequent muscle wasting (sarcopenia) are common ageing complications. It is knowing to be also associated with dementia. Our programme will test the cytoprotective functions of vitamin E combined with the cortisol-lowering effect of chocolate polyphenols (PP), in combination with muscle anabolic effect of adequate dietary protein intake and physical exercise to prevent the age-dependent decline of muscle mass and its key underpinning mechanisms including mitochondrial function, and nutrient metabolism in muscle in the elderly.
In 2020, a 6-month double-blind randomised controlled trial in 75 predementia older people was launched to prevent muscle mass loss, in respond to the ‘Joint Programming Initiative A healthy diet for a healthy life’. In the run-in phase, participants will be stabilised on a protein-rich diet (0.9–1.0 g protein/kg ideal body weight/day) and physical exercise programme (high-intensity interval training specifically developed for these subjects). Subsequently, they will be randomised into three groups (1:1:1). The study arms will have a similar isocaloric diet and follow a similar physical exercise programme. Control group (n=25) will maintain the baseline diet; intervention groups will consume either 30 g/day of dark chocolate containing 500 mg total PP (corresponding to 60 mg epicatechin) and 100 mg vitamin E (as RRR-alpha-tocopherol) (n=25); or the high polyphenol chocolate without additional vitamin E (n=25). Muscle mass will be the primary endpoint. Other outcomes are neurocognitive status and previously identified biomolecular indices of frailty in predementia patients. Muscle biopsies will be collected to assess myocyte contraction and mitochondrial metabolism. Blood and plasma samples will be analysed for laboratory endpoints including nutrition metabolism and omics.
All the ethical and regulatory approvals have been obtained by the ethical committees of the Azienda Ospedaliera Universitaria Integrata of Verona with respect to scientific content and compliance with applicable research and human subjects’ regulation. Given the broader interest of the society toward undernutrition in the elderly, we identify four main target audiences for our research activity: national and local health systems, both internal and external to the project; targeted population (the elderly); general public; and academia. These activities include scientific workshops, public health awareness campaigns, project dedicated website and publication is scientific peer-review journals.
by Lars M. Tingelstad, Truls Raastad, Kevin Till, Live S. Luteberget
BackgroundPhysical development during adolescence is crucial for athletes in team sports, as it prepares them for the high sport demands at the senior level. While physical development in non-athletes are well-documented, a comprehensive understanding of adolescent athletes’ development, including the potential effects of team sports participation and training load, is lacking.
ObjectivesThe study aimed to investigate the development of physical characteristics in team sport athletes during adolescence (12–20 years) and explore the impact of training load.
MethodsA systematic search of the databases PubMed, SPORTDiscus and Web of Science were conducted combining keywords related to physical characteristics, youth athletes, team sport and study design. Criteria for inclusion were: (1) team sport athletes aged 12–20 years, (2) cross-sectional or longitudinal designs investigating physical characteristics, (3) comparisons across different age groups, (4) peer-reviewed original article, (5) written in English, and (6) available results from physical testing. Results were normalized and weighted based on sample size.
Results176 eligible articles were identified. The results showed consistent annual improvement in most physical characteristics from 12 to 16 years for both sexes (e.g., boys: lower body strength 14.3%; intermittent endurance 11%; countermovement jump height 6.7%; change of direction 2.8%; 30 m sprint 3.6%, and girls: lower body strength 9.4%; intermittent endurance 12.1%; countermovement jump 4.7%; change of direction 3.3%; 30 m sprint 1.9%). Only 4 studies investigated the effect of training load on physical development.
ConclusionsAlthough both sexes consistently improved through adolescence, girls tended to have less pronounced physical development compared to boys, likely due to lower increase in lean mass and limb length. The existing evidence do not definitively establish whether team sports participation, compared to studies examining non-athletes, or training load have an additive effect on physical development during this period.
by Bennet S. Cho, Scott C. Fligor, Gillian L. Fell, Jordan D. Secor, Savas T. Tsikis, Amy Pan, Lumeng J. Yu, Victoria H. Ko, Duy T. Dao, Lorenzo Anez-Bustillos, Thomas I. Hirsch, Jenny Lund, Arild C. Rustan, David A. Fraser, Kathleen M. Gura, Mark Puder
BackgroundParenteral (intravenous) nutrition is lifesaving for patients with intestinal failure, but long-term use of parenteral nutrition often leads to liver disease. SEFA-6179 is a synthetic medium-chain fatty acid analogue designed to target multiple fatty acid receptors regulating metabolic and inflammatory pathways. We hypothesized that SEFA-6179 would prevent hepatosteatosis and lipotoxicity in a murine model of parenteral nutrition-induced hepatosteatosis.
MethodsTwo in vivo experiments were conducted. In the first experiment, six-week-old male mice were provided an ad lib fat-free high carbohydrate diet (HCD) for 19 days with orogastric gavage of either fish oil, medium-chain triglycerides, or SEFA-6179 at a low (0.3mmol/kg) or high dose (0.6mmol/kg). In the second experiment, six-week-old mice were provided an ad lib fat-free high carbohydrate diet for 19 days with every other day tail vein injection of saline, soybean oil lipid emulsion, or fish oil lipid emulsion. Mice then received every other day orogastric gavage of medium-chain triglyceride vehicle or SEFA-6179 (0.6mmol/kg). Hepatosteatosis was assessed by a blinded pathologist using an established rodent steatosis score. Hepatic lipid metabolites were assessed using ultra-high-performance liquid chromatography-mass spectrometry. Effects of SEFA-6179 on fatty acid oxidation, lipogenesis, and fatty acid uptake in human liver cells were assessed in vitro.
ResultsIn the first experiment, mice receiving the HCD with either saline or medium-chain triglyceride treatment developed macrovesicular steatosis, while mice receiving fish oil or SEFA-6179 retained normal liver histology. In the second experiment, mice receiving a high carbohydrate diet with intravenous saline or soybean oil lipid emulsion, along with medium chain triglyceride vehicle treatment, developed macrovescular steatosis. Treatment with SEFA-6179 prevented steatosis. In each experiment, SEFA-6179 treatment decreased arachidonic acid metabolites as well as key molecules (diacylglycerol, ceramides) involved in lipotoxicity. SEFA-6179 increased both β- and complete fatty oxidation in human liver cells, while having no impact on lipogenesis or fatty acid uptake.
ConclusionsSEFA-6179 treatment prevented hepatosteatosis and decreased toxic lipid metabolites in a murine model of parenteral nutrition-induced hepatosteatosis. An increase in both β- and complete hepatic fatty acid oxidation may underlie the reduction in steatosis.
In older adults with type 2 diabetes (T2D), overtreatment with hypoglycaemic drugs (HDs: sulfonylureas, glinides and/or insulins) is frequent and associated with increased 1-year mortality. Deintensification of HD is thus a key issue, for which evidence is though limited. The primary objective of this study will be to estimate the effect of deintensifying HD on clinical outcomes (hospital admission or death) within 3 months in older adults (≥75 years) with T2D.
We will emulate with real-world data a target trial, within The Health Improvement Network cohort, a large-scale database of data collected from electronic medical records of 2000 general practitioners in France. From 1 January 2010 to 28 February 2019, we will include eligible patients ≥75 years who will have T2D, a stable dose of HDs, glycated haemoglobin A1c (HbA1c) value 75 mmol/mol within 1 year. Participants will be followed from baseline to 12 months after randomisation, administrative censoring, or death, whichever occurs first. A pooled logistic regression will be used to estimate the treatment effect on the incidence of the outcomes.
No ethical approval is needed for using retrospectively this fully anonymised database. The results will be disseminated during conferences and through publications in scientific journals.
Se trata de un relato biográfico de un profesional de enfermería con gran experiencia en la atención a pacientes con patologías mentales. Una sólida formación que tal y como relata en un principio fue autodidacta. El profesional manifiesta la necesidad de una formación previa al contacto a nivel sanitario con este tipo de pacientes. En su testimonio muestra su punto de vista respecto a la atención desarrollada a lo largo de los años de su trayectoria profesional, los perjuicios existentes en la sociedad ante estos pacientes y expone las perspectivas de mejora respecto al tema tratado especialmente en el ámbito donde actualmente trabaja una zona rural de Atención primaria de salud. Perteneciente a una asociación de enfermería con gran influencia en la evolución de la profesión enfermera, reflexiona sobre la importancia de la formación continuada y el desarrollo de las especialidades como meta para mejorar la prestación de cuidados.
Introducción: Existen algunos estudios sobre los beneficios de ZhiNeng QiGong, pero aún muy pocos en el contexto de la pandemia por la COVID-19 y relacionados con el cuidado holístico. Objetivo: Describir los beneficios de Zhineng Qigong en la salud integral de adultos practicantes durante la COVID-19. Método: Investigación cualitativa descriptiva exploratoria. La muestra fue no probabilística por conveniencia, lograda por técnica de la saturación y redundancia de datos, participaron 13 practicantes de disciplina incorporados en la tercera Certificación Internacional de Zhineng Qigong, previo consentimiento informado. La información fue recolectada por entrevista online y procesada según el análisis de contenido. Resultados: Se encontraron cinco categorías: salud física, mental, social, espiritual y ecológica, donde en todas se encontró cambios positivos de fortalecimiento y sanación individual con irradiación hacia su entorno familiar y social. Conclusiones: Todos los practicantes de Zhineng Qigong experimentaron sanación física y emocional, mejoras en sus relaciones familiares y laborales. Asimismo, sienten vitalidad, paz interior, conexión con el universo y la naturaleza. La mayoría indicaron que no contrajeron la COVID-19 porque con la práctica mejoraron su sistema inmunológico y la respiración.
Se trata de un relato biográfico de un profesional de enfermería con gran experiencia en la atención a pacientes con patologías mentales. Una sólida formación que tal y como relata en un principio fue autodidacta. El profesional manifiesta la necesidad de una formación previa al contacto a nivel sanitario con este tipo de pacientes. En su testimonio muestra su punto de vista respecto a la atención desarrollada a lo largo de los años de su trayectoria profesional, los perjuicios existentes en la sociedad ante estos pacientes y expone las perspectivas de mejora respecto al tema tratado especialmente en el ámbito donde actualmente trabaja una zona rural de Atención primaria de salud. Perteneciente a una asociación de enfermería con gran influencia en la evolución de la profesión enfermera, reflexiona sobre la importancia de la formación continuada y el desarrollo de las especialidades como meta para mejorar la prestación de cuidados.
El litio es el estabilizador del ánimo en uso más extendido. Posee un estrecho margen terapéutico, siendo tóxico en altas concentraciones. Esta guía va dirigida a profesionales y personas que estén utilizando Litio, pretende facilitar la toma correcta y el buen manejo de esta medicación [Fragmento de texto].
Objetivo principal: Develar desde primera persona el misterio existente en la mente de un paciente portador de Trastorno Obsesivo Compulsivo y que además comparte el atributo de ser profesional de enfermería. Metodología: Narrativa, autobiográfico. Resultados principales: El Trastorno obsesivo compulsivo es una enfermedad de baja prevalencia caracterizada por la aparición de ideas intrusivas que desencadenan la realización de acciones compulsivas acompañados de angustia, sufrimiento psiquiátrico y estigmatización de quien la vive. Discusión principal: Es importante explorar en la vivencia del sufrimiento psiquiátrico para relevar la importancia del tratamiento multidisciplinario y las redes de apoyo para la contención de los pacientes portadores de TOC.
Objetivos: Describir el papel del equipo de enfermería en el cuidado de pacientes con sospecha de infarto agudo del miocardio. Metodo-logía: revisión integradora de la literatura, utilizando las bases de datos MEDLINE, PUBMED, LILACS, CUIDEN, CINAHL, y las Prácticas Recomendadas de la Sociedad Brasileña de Cardiología. Se incluyeron publicaciones de 2010 a 2021, que estuvieran en portugués y de acceso gratuito. Resultados: se obtuvo una muestra final de 26 artículos, siendo seleccionados y agrupados en tres categorías temáti-cas: A) Conocimiento del equipo de enfermeria sobre los protocolos para el atendimiento a los pacientes con sospecha de Infarto agudo de miocardio B) la Sistematización de la asistencia de enfermeria durante el atendimiento inicial; C) Papel del equipo de enfermeria. Conclusiones: el equipo de enfermeria es visto como parte fundamental en las unidades de atención, por lo tanto, es necesario actualizar a estos profesionales para un mejor soporte técnico y científico, basado en la evidencia.
Objetivo: Describir el abordaje del dolor en pacientes con insuficiencia cardíaca, según lo encontrado en la literatura. Metodología: se realizó una investigación bibliográfica con búsqueda en las bases de datos MEDLINE, PUBMED, LILACS, CUIDEN, CINAHL, utilizando los descriptores Manejo del dolor, insuficiencia cardíaca y Automedicación, junto con el operador booleano AND. Se seleccionaron artículos en portugués, publicados entre 2010 y 2020, que respondieron al objetivo de la investigación. Las publicaciones duplicadas fueron ex-cluidas al final de las búsquedas en cada base de datos, obteniendo una muestra final de 31 artículos. Resultados: se encontró que el dolor se puede clasificar: 1) Según su naturaleza en nociceptivo (que puede ser somático y visceral), neuropático y mixto) y 2) Según su intensidad: en agudo, crónico o recurrente. Por lo tanto, el abordaje del dolor dependerá de su origen y de la necesidad del individuo.
Objetivo: identificar la producción científica que trate sobre cuidados de enfermería durante el período pre y postoperatorio de pacientes sometidos a cirugía cardíaca. Metodología: Revisión integradora de la literatura con enfoque cualitativo, realizada en las bases de datos CUIDEN, CINAHL, LILACS, LATINDEX, SciELO (Scientific Electronic Library Online) y BDENF (Base de datos bibliográfica especializada en el área de enfermería de Brasil) con un período de tiempo de 2007 a 2020. Resultados: Los principales diagnósticos de enfermería encontrados para el preoperatorio fueron: ansiedad y riesgo de infección, aspiración e integridad de la piel. Los diagnósticos para el postoperatorio fueron: dolor agudo, disminución del gasto cardíaco, alteración del intercambio de gases, riesgo de desequilibrio en el volumen de líquidos y electrolitos, alteraciones en la percepción sensorial, perfusión ineficaz del tejido renal, termorregulación ineficaz y escaso conocimiento sobre las actividades de autocuidados. Conclusión: La sistematización de la atención de enfermería se considera fundamental, para garantizar una atención segura y de calidad a los pacientes sometidos a procedimientos quirúrgicos.
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