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1.
J Dairy Sci ; 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39067750

RESUMEN

Genome-wide association studies (GWAS) are employed to identify genomic regions and candidate genes associated with several traits. The aim of this study was to perform a GWAS to identify causative variants and genes associated with milk yield, frame, and udder conformation traits in Gir dairy cattle. Body conformation traits were classified as "frame," and "udder" traits for this study. After genotyping imputation and quality control 42,105 polymorphisms were available for analyses and 24,489 cows with pedigree information had phenotypes. First, P-value was calculated based on the variance of the prediction error of the SNP-effects on the first iteration. After that, 2 more iterations were performed to carry out the weighted single-step genome-wide association methodology, performed using genomic moving windows defined based on linkage disequilibrium. The significant SNPs and top 10 windows explaining the highest percentage of additive genetic variance were selected and used for QTL and gene annotation. The variants identified in our work overlapped with QTLs from the animal QTL database on chromosomes 1 to 23, except for chromosome 4. The Gir breed is less studied than the Holstein breed and as such the animal QTL database is biased to Holstein results. Hence it is noteworthy that our GWAS had similarities with previously described QTLs. These previously known QTLs were related to milk yield, body height, rump angle, udder width, and udder depth. In total, 5 genes were annotated. Of these genes, FAM13A and CMSS1 had been previously related to bone and carcass weight in cattle.

2.
Neurología (Barc., Ed. impr.) ; 38(8): 550-559, Oct. 20232. tab, ilus
Artículo en Español | IBECS | ID: ibc-226322

RESUMEN

Introducción: La inflamación relacionada con la angiopatía amiloide es una entidad caracterizada por una respuesta inflamatoria alrededor de los depósitos de beta amiloide de la microcirculación cerebral. Métodos: Revisión retrospectiva de una serie de pacientes con inflamación relacionada con angiopatía amiloide, que cumplieran criterios clínico-radiológicos o con diagnóstico histopatológico confirmado. Resultados: Se incluyeron siete pacientes, cinco varones, con edad media de 79 años. El inicio fue agudo o subagudo en seis de los casos. La clínica más frecuente fue deterioro cognitivo (n = 6), alteraciones de conducta (n = 5), crisis epilépticas (n = 5), focalidad neurológica (n = 4) y cefalea (n = 2). El líquido cefalorraquídeo fue anormal en tres de cinco casos (pleocitosis linfocitaria e hiperproteinorraquia). Las imágenes de resonancia magnética cerebral más frecuentes consistieron en microhemorragias (n = 7), hiperintensidades subcorticales en secuencia T2-FLAIR (n = 7) y realce leptomeníngeo (n = 6). La afectación fue bilateral en tres de los casos, con predominio en regiones parieto-occipitales (n = 5). Se realizó una tomografía por emisión de positrones (PET) de amiloide en dos pacientes, resultando positiva en uno. Se obtuvo la confirmación histopatológica mediante una biopsia en dos de los casos. Todos los sujetos recibieron tratamiento inmunosupresor, objetivándose una respuesta clínica y radiológica inicial favorable, con recaída radiológica en dos de los casos tras la retirada del tratamiento, y mejorando tras la reinstauración. Conclusiones: El diagnóstico resulta imprescindible de cara a iniciar un tratamiento precoz, ya que ha demostrado mejorar el pronóstico y disminuir las recurrencias. Si bien el diagnóstico definitivo es histopatológico, los criterios clínico-radiológicos permiten el diagnóstico de esta entidad sin necesidad de biopsia.(AU)


Introduction: Cerebral amyloid angiopathy–related inflammation (CAA-ri) is an entity characterised by an inflammatory response to β-amyloid deposition in the walls of cerebral microvessels. Methods: We conducted a retrospective review of a series of patients with a diagnosis of CAA-ri according to histopathological study findings or clinical-radiological diagnostic criteria. Results: The study included 7 patients (5 men) with a mean age of 79 years. Disease onset was acute or subacute in 6 patients. The most frequent symptoms were cognitive impairment (n = 6), behavioural alterations (n = 5), epileptic seizures (n = 5), focal neurological signs (n = 4), and headache (n = 2). Cerebrospinal fluid was abnormal in 3 patients (lymphocytic pleocytosis and high protein levels). The most frequent MRI findings were microbleeds (n = 7), subcortical white matter hyperintensities on T2-FLAIR sequences (n = 7), and leptomeningeal enhancement (n = 6). Lesions were bilateral in 3 patients and most frequently involved the parieto-occipital region (n = 5). Amyloid PET studies were performed in 2 patients, one of whom showed pathological findings. Two patients underwent brain biopsy, which confirmed diagnosis. All patients received immunosuppressive therapy. An initially favourable clinical-radiological response was observed in all cases, with 2 patients presenting radiological recurrence after treatment withdrawal, with a subsequent improvement after treatment was resumed. Conclusions: Early diagnosis of CAA-ri is essential: early treatment has been shown to improve prognosis and reduce the risk of recurrence. Although a histopathological study is needed to confirm diagnosis, clinical-radiological criteria enable diagnosis without biopsy.(AU)


Asunto(s)
Humanos , Masculino , Anciano , Angiopatía Amiloide Cerebral/complicaciones , Inflamación , Disfunción Cognitiva , Convulsiones , Neuroimagen , Neurología , Enfermedades del Sistema Nervioso , Estudios Retrospectivos
3.
Neurologia (Engl Ed) ; 38(8): 550-559, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37437655

RESUMEN

INTRODUCTION: Cerebral amyloid angiopathy-related inflammation (CAA-ri) is an entity characterised by an inflammatory response to ß-amyloid deposition in the walls of cerebral microvessels. METHODS: We conducted a retrospective review of a series of patients with a diagnosis of CAA-ri according to histopathological study findings or clinical-radiological diagnostic criteria. RESULTS: The study included 7 patients (5 men) with a mean age of 79 years. Disease onset was acute or subacute in 6 patients. The most frequent symptoms were cognitive impairment (n = 6), behavioural alterations (n = 5), epileptic seizures (n = 5), focal neurological signs (n = 4), and headache (n = 2). Cerebrospinal fluid was abnormal in 3 patients (lymphocytic pleocytosis and high protein levels). The most frequent MRI findings were microbleeds (n = 7), subcortical white matter hyperintensities on T2-FLAIR sequences (n = 7), and leptomeningeal enhancement (n = 6). Lesions were bilateral in 3 patients and most frequently involved the parieto-occipital region (n = 5). Amyloid PET studies were performed in 2 patients, one of whom showed pathological findings. Two patients underwent brain biopsy, which confirmed diagnosis. All patients received immunosuppressive therapy. An initially favourable clinical-radiological response was observed in all cases, with 2 patients presenting radiological recurrence after treatment withdrawal, with a subsequent improvement after treatment was resumed. CONCLUSIONS: Early diagnosis of CAA-ri is essential: early treatment has been shown to improve prognosis and reduce the risk of recurrence. Although a histopathological study is needed to confirm diagnosis, clinical-radiological criteria enable diagnosis without biopsy.


Asunto(s)
Angiopatía Amiloide Cerebral , Masculino , Humanos , Anciano , Angiopatía Amiloide Cerebral/complicaciones , Angiopatía Amiloide Cerebral/diagnóstico por imagen , Inflamación/patología , Imagen por Resonancia Magnética , Radiografía , Estudios Retrospectivos
4.
Enferm. intensiva (Ed. impr.) ; 34(2): 60-69, Abr-Jun 2023. tab
Artículo en Español | IBECS | ID: ibc-219582

RESUMEN

Objetivo: Conocer las características de los cambios de turnos que realizan las enfermeras de Unidades de Cuidados Críticos en España. Método: Estudio descriptivo y transversal, cuya población eran enfermeros y enfermeras que trabajasen en Unidades de Cuidados Críticos de España. Se utilizó un cuestionario ad hoc que exploraba las características del proceso, la formación recibida, el olvido de información y la influencia de esta actividad en la atención al paciente. El cuestionario era online y la difusión se realizó a través de redes sociales. La muestra fue seleccionada por conveniencia. Se realizó un análisis descriptivo según la naturaleza de las variables y comparación de grupos a través de ANOVA con R software versión 4.0.3 (R Project for Statistical Computing).Resultado: El total de la muestra fueron 420 enfermeras y enfermeros. La mayoría de participantes (79,5%) contestaron que realizan está actividad de forma dirigida, de enfermera saliente a enfermera entrante. El espacio físico donde se realizaba el cambio de turno variaba en función del tamaño de la unidad (p <0,05). La realización interdisciplinar del cambio de turno fue escasa (p <0,05). En el último mes (enero del 2020), respecto al momento de recogida de datos, el 29,5% contactó con la unidad por olvido de información relevante, utilizando WhatsApp como primer canal para transmitir esta información. Conclusiones: Existe una falta de estandarización del proceso, en cuanto al espacio físico donde se realiza, las herramientas para estructurar la información, la participación de otros profesionales y el uso de canales de comunicación no oficiales para contactar por información omitida durante la realización del traspaso. El cambio de turno se identificó como un proceso vital para garantizar la continuidad de los cuidados y seguridad del paciente, por lo que es importante seguir investigando sobre el traspaso de información.(AU)


Aim: To know the characteristics of the handover performed by nurses working in Critical Care Units in Spain. Methods: Descriptive and cross-sectional study, whose population was nurses working in Critical Care Units in Spain. An ad hoc questionnaire was used to explore the characteristics of the process, the training received, the information forgotten and the influence of this activity on patient care. The questionnaire was online and dissemination was done through social networks. The sample was selected by convenience. A descriptive analysis was performed according to the nature of the variables and comparison of groups through ANOVA with R software version 4.0.3 (R Project for Statistical Computing). Results: The sample was 420 nurses. Most of them answered that (79,5%) perform this activity in an individual way, from outgoing nurse to incoming nurse. Location varied according to the size of the unit (P<0,05). Interdisciplinary handover was rare (P<.05). In the last month, with regard to the time of data collection, 29,5% had to contact the unit due to forgetting relevant information, using WhatsApp as the first channel to transmit this information. Conclusions: There is a lack of standardization in the handoff between shifts, in terms of the physical space where it is done, tools to structure the information, participation of other professionals and the use of unofficial communication channels to contact for omitted information during the handover. Shift change was identified as a vital process to ensure continuity of care and patient safety, so further researchs are important for patients handoffs.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Comunicación , Transferencia de Pacientes , Pase de Guardia , Seguridad del Paciente , Atención de Enfermería , Epidemiología Descriptiva , Estudios Transversales
5.
Enferm Intensiva (Engl Ed) ; 34(2): 60-69, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36934076

RESUMEN

AIM: To know the characteristics of the handover performed by nurses working in Critical Care Units in Spain. METHODS: Descriptive and cross-sectional study, whose population was nurses working in Critical Care Units in Spain. An ad hoc questionnaire was used to explore the characteristics of the process, the training received, the information forgotten and the influence of this activity on patient care. The questionnaire was online and dissemination was done through social networks. The sample was selected by convenience. A descriptive analysis was performed according to the nature of the variables and comparison of groups through ANOVA with R software version 4.0.3 (R Project for Statistical Computing). RESULTS: The sample was 420 nurses. Most of them answered that (79,5%) perform this activity in an individual way, from outgoing nurse to incoming nurse. Location varied according to the size of the unit (p<0,05). Interdisciplinary handover was rare (p<0.05). In the last month, with regard to the time of data collection, 29,5% had to contact the unit due to forgetting relevant information, using WhatsApp as the first channel to transmit this information. CONCLUSIONS: There is a lack of standardization in the handoff between shifts, in terms of the physical space where it is done, tools to structure the information, participation of other professionals and the use of unofficial communication channels to contact for omitted information during the handover. Shift change was identified as a vital process to ensure continuity of care and patient safety, so further researchs are important for patients handoffs.


Asunto(s)
Enfermeras y Enfermeros , Pase de Guardia , Humanos , Estudios Transversales , Unidades de Cuidados Intensivos , Cuidados Críticos
6.
Enferm Intensiva (Engl Ed) ; 33(2): 58-66, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35534412

RESUMEN

AIM: The main aim of this investigation was to analyse the specificity and sensibility of the COMFORT Behaviour Scale (CBS-S) in assessing grade of pain, sedation, and withdrawal syndrome in paediatric critical care patients. METHOD: An observational, analytical, cross-sectional and multicentre study conducted in Level III Intensive Care Areas of 5 children's university hospitals. Grade of sedation was assessed using the Spanish version of the CBS-S and the Bispectral Index on sedation, once per shift over one day. Grade of withdrawal was determined using the CBS-S and the Withdrawal Assessment Tool-1, once per shift over three days. RESULTS: A total of 261 critically ill paediatric patients with a median age of 5.07 years (P25:0.9-P75:11.7) were included in this study. In terms of the predictive capacity of the CBS-S, it obtained a Receiver Operation Curve of .84 (sensitivity of 81% and specificity of 76%) in relation to pain; .62 (sensitivity of 21% and specificity of 78%) in relation to sedation grade, and .73% (sensitivity of 40% and specificity of 74%) in determining withdrawal syndrome. CONCLUSIONS: The Spanish version of the COMFORT Behaviour Scale could be a useful, sensible and easy scale to assess the degree of pain, sedation and pharmacological withdrawal of critically ill paediatric patients.


Asunto(s)
Enfermedad Crítica , Síndrome de Abstinencia a Sustancias , Niño , Preescolar , Cuidados Críticos , Estudios Transversales , Humanos , Unidades de Cuidado Intensivo Pediátrico , Dolor , Síndrome de Abstinencia a Sustancias/diagnóstico
7.
Enferm. intensiva (Ed. impr.) ; 33(2): 1-9, Abr-Jun 2022. tab, graf
Artículo en Español | IBECS | ID: ibc-203600

RESUMEN

Objetivo: El objetivo principal de la investigación fue analizar la especificidad y sensibilidad de la escala COMFORT Behavior Scale-Versión española (CBS-ES) en la determinación del grado de dolor, sedación y síndrome de abstinencia.Método: Se llevó a cabo un estudio observacional, analítico y transversal y multicéntrico en unidades de cuidados intensivos pediátricas de 5 hospitales españoles. Se valoró el grado de sedación del paciente crítico pediátrico de forma simultánea empleando para ello la CBS-ES y registrando los valores del Bispectral Index Sedation, una vez por turno durante un día. El grado de abstinencia se determinó una vez por turno, durante 3 días, empleando de forma simultánea la CBS-ES y la Withdrawal Assessment Tool-1.Resultados: Se incluyeron en el estudio un total de 261 pacientes críticos pediátricos con una mediana de 1,61 años (P25: 0,35-P75: 6,55). Por lo que a la capacidad predictiva de la CBS-ES se refiere se obtuvo un área bajo la curva de 0,84 (sensibilidad del 81% y especificidad del 76%) con relación al dolor; de 0,62 (sensibilidad del 27% y especificidad del 78%) en el caso de la sedación, y de 0,73 (sensibilidad del 40% y especificidad del 74%) en el del síndrome de abstinencia.Conclusiones: Se ha podido contrastar que la CBS-ES podría ser un instrumento sensible, útil y fácil de emplear para valorar el grado de dolor, sedación y síndrome de abstinencia farmacológico del paciente crítico pediátrico.


Aim: The main aim of this investigation was to analyse the specificity and sensibility of the COMFORT Behaviour Scale (CBS-S) in assessing grade of pain, sedation, and withdrawal syndrome in paediatric critical care patients.Method: An observational, analytical, cross-sectional and multicentre study conducted in Level III Intensive Care Areas of 5 children's university hospitals. Grade of sedation was assessed using the Spanish version of the CBS-S and the Bispectral Index on sedation, once per shift over one day. Grade of withdrawal was determined using the CBS-S and the Withdrawal Assessment Tool-1, once per shift over three days.Results: A total of 261 critically ill paediatric patients with a median age of 5.07 years (P25:0.9-P75:11.7) were included in this study. In terms of the predictive capacity of the CBS-S, it obtained a Receiver Operation Curve of .84 (sensitivity of 81% and specificity of 76%) in relation to pain; .62 (sensitivity of 21% and specificity of 78%) in relation to sedation grade, and .73% (sensitivity of 40% and specificity of 74%) in determining withdrawal syndrome.Conclusions: The Spanish version of the COMFORT Behaviour Scale could be a useful, sensible and easy scale to assess the degree of pain, sedation and pharmacological withdrawal of critically ill paediatric patients.


Asunto(s)
Humanos , Niño , Behaviorismo , Unidades de Cuidado Intensivo Pediátrico , Dolor , Síndrome de Abstinencia a Sustancias , Síndrome de Abstinencia a Sustancias/diagnóstico , Estudios Transversales , Enfermería , España , Cuidados Críticos , Niño
11.
Enferm. intensiva (Ed. impr.) ; 32(4): 189-197, Octubre - Diciembre 2021. tab, ilus
Artículo en Español | IBECS | ID: ibc-220866

RESUMEN

Objetivos Determinar los niveles de sedación del paciente crítico pediátrico mediante el Biespectral Index Sensor (BIS) y analizar la relación entre el grado de sedación y las variables sociodemográficas y clínicas del paciente. Métodos Estudio observacional, analítico, transversal y multicéntrico de mayo de 2018 a enero de 2020 desarrollado en 5unidades de cuidados intensivos pediátricas del territorio español. Se registraron como variables sociodemográficas y clínicas el sexo, la edad, motivo de ingreso, si el paciente tenía enfermedad crónica, el tipo y número de fármacos que se le estaban administrando y la duración de la estancia. Además, se anotaron los valores del BIS una vez por turno, mañana y noche, durante 24 h. Resultados Se incluyó en el estudio a un total de 261 pacientes, de los cuales el 53,64% eran del sexo masculino, con una edad mediana de 1,61 años (0,35-6,55). El 70,11% (n=183) estaban analgosedados y monitorizados con el sensor BIS. Se observó una mediana en las puntuaciones globales de BIS de 51,24±14,96 en el turno de mañana y de 50,75±15,55 en el de noche. No se detectó significación estadística al comparar los niveles de BIS y las diversas variables sociodemográficas y clínicas del paciente crítico pediátrico. Conclusiones A pesar de las limitaciones inherentes al sensor BIS, los estudios existentes y el que aquí se presenta muestran que el BIS es un instrumento útil para monitorizar el grado de sedación en el paciente crítico pediátrico. Se requieren más investigaciones que objetiven qué variables relacionadas con el paciente tienen más peso en al grado de analgosedación y que contrasten clínicamente la eficacia de escalas como, por ejemplo, la COMFORT Behavior Scale versión española. (AU)


Aims To determine the grade of sedation in the critically ill paediatric patient using Biespectral Index Sensor (BIS) and to analyse its relationship with sociodemographic and clinical patient variables. Methods Observational, analytical, cross-sectional and multicentre study performed from May 2018 to January 2020 in 5 Spanish paediatric critical care units. Sex, age, reason for admission, presence of a chronic pathology, type and number of drugs and length of stay were the sociodemographic and clinical variables registered. Furthermore, the grade of sedation was assessed using BIS, 11per shift over 24hours. Results A total of 261 paediatric patients, 53.64% of whom were male, with a median age of 1.61 years (0.35-6.55), were included in the study. Of the patients, 70.11% (n=183) were under analgosedation and monitored using the BIS sensor. A median of BIS values of 51.24±14.96 during the morning and 50.75±15.55 during the night were observed. When comparing BIS values and sociodemographic and clinical paediatric variables no statistical significance was detected. Conclusions Despite the limitations of the BIS, investigations and the present study show that BIS could be a useful instrument to assess grade of sedation in critically ill paediatric patients. However, further investigations which determine the sociodemographic and clinical variables involved in the grade of paediatric analgosedation, as well as studies that contrast the efficacy of clinical scales like the COMFORT Behaviour Scale-Spanish version, are required. (AU)


Asunto(s)
Humanos , Enfermería , Pediatría , Unidades de Cuidados Intensivos , Analgesia , España , Estudios Observacionales como Asunto , Estudios Transversales , Condiciones Sociales , Demografía
12.
Enferm Intensiva (Engl Ed) ; 32(4): 189-197, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34772640

RESUMEN

AIMS: To determine the grade of sedation in the critically ill paediatric patient using Biespectral Index Sensor (BIS) and to analyse its relationship with sociodemographic and clinical patient variables. METHODS: Observational, analytical, cross-sectional and multicentre study performed from May 2018 to January 2020 in 5 Spanish paediatric critical care units. Sex, age, reason for admission, presence of a chronic pathology, type and number of drugs and length of stay were the sociodemographic and clinical variables registered. Furthermore, the grade of sedation was assessed using BIS, once per shift over 24 h. RESULTS: A total of 261 paediatric patients, 53.64% of whom were male, with a median age of 1.61 years (0.35-6.55), were included in the study. Of the patients, 70.11% (n = 183) were under analgosedation and monitored using the BIS sensor. A median of BIS values of 51.24 ±â€¯14.96 during the morning and 50.75 ±â€¯15.55 during the night were observed. When comparing BIS values and sociodemographic and clinical paediatric variables no statistical significance was detected. CONCLUSIONS: Despite the limitations of the BIS, investigations and the present study show that BIS could be a useful instrument to assess grade of sedation in critically ill paediatric patients. However, further investigations which determine the sociodemographic and clinical variables involved in the grade of paediatric analgosedation, as well as studies that contrast the efficacy of clinical scales like the COMFORT Behaviour Scale-Spanish version, are required.


Asunto(s)
Anestesia , Enfermedad Crítica , Niño , Estudios Transversales , Hospitalización , Humanos , Lactante , Unidades de Cuidado Intensivo Pediátrico , Masculino
13.
Enferm. intensiva (Ed. impr.) ; 32(3): 133-144, Julio - Septiembre 2021. graf, tab
Artículo en Español | IBECS | ID: ibc-220631

RESUMEN

Objetivo Explorar la experiencia de las enfermeras en relación con la facilitación de la visita infantil a la UCIP. Método Estudio fenomenológico interpretativo mediante entrevistas en profundidad. El estudio se desarrolló en las UCIP de dos centros públicos madrileños de nivel IIIC. Participaron 12 enfermeras con experiencia mayor de dos años en UCIP que, en el momento de la entrevista, prestaban servicios en dichas unidades. Además, se entrevistó a una psicóloga con experiencia de cuatro años en UCIP cuya información se consideró en el contexto de los datos en la sombra. La información se analizó mediante un análisis temático del discurso. ResultadosLa experiencia de las enfermeras en relación a la facilitación de la visita infantil a la UCIP se puede condensar en cuatro temas: el emerger de la demanda, la preparación progresiva, la toma de decisiones desde el consenso y la creación de espacios de intimidad. Conclusiones Las experiencias de facilitación de la visita responden, principalmente, a la demanda de las familias que viven hospitalizaciones prologadas o al final de la vida. El rol de la enfermera es de acompañamiento reconociendo la labor prioritaria de los padres en la preparación de los niños y el desarrollo de la visita. Las enfermeras se sienten inseguras y faltas de recursos para el apoyo emocional y reclaman protocolos de actuación que orienten la intervención y toma de decisiones. (AU)


Aim To explore nurses’ experience related to promoting the visits of siblings to PICU. Methods An interpretative phenomenological study was carried out through in-depth interviews in two PICUs belonging to third level public hospitals in Madrid. Twelve nurses with more than two years of experience in PICU were interviewed. They all were working in PICU during the study. Furthermore, a PICU psychologist with an experience of four years was interviewed and this was considered shadowed data. Data analysis followed a thematic discourse analysis. Results Nurses’ experience of facilitating children's visits to PICU can be condensed into four themes: emerging demand for visits, progressive preparation, decision-making through common consensus and creating intimate spaces. Conclusions The experience of nurses in facilitating visits is mainly in response to the demand of families going through prolonged hospitalisation or end-of-life situations. The role of the nurse is one of accompaniment, recognising the major role of parents in the preparation of children and in developing the visit. Nurses feel insecure and lack resources for emotional support and demand action protocols to guide intervention and decision making. (AU)


Asunto(s)
Humanos , Preescolar , Niño , Niño , Unidades de Cuidado Intensivo Pediátrico , Enfermería de la Familia , Defensa del Niño , España
14.
Enferm Intensiva (Engl Ed) ; 32(3): 133-144, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34391734

RESUMEN

BACKGROUND: Family process disruption is one of the main consequences of the hospitalization of a critically ill child in a Paediatric Intensive Care Unit (PICU). Children's visits to PICU may help improve family coping. However, this is not standard practice and nurses' experiences in facilitating children's visits to units where it is encouraged is unknown. AIM: To explore nurses' experience related to promoting the visits of siblings to PICU. METHODS: An interpretative phenomenological study was carried out through in-depth interviews in two PICUs belonging to third level public hospitals in Madrid. Twelve nurses with more than two years of experience in PICU were interviewed. They were all were working in PICU during the study. Furthermore, a PICU psychologist with an experience of four years was interviewed and this was considered shadowed data. Data analysis followed a thematic discourse analysis. RESULTS: Nurses' experience of facilitating children's visits to PICU can be condensed into four themes: emerging demand for visits, progressive preparation, decision-making through common consensus and creating intimate spaces. CONCLUSIONS: The experience of nurses in facilitating visits is mainly in response to the demand of families going through prolonged hospitalisation or end-of-life situations. The role of the nurse is one of accompaniment, recognising the major role of parents in the preparation of children and in developing the visit. Nurses feel insecure and lack resources for emotional support and demand action protocols to guide intervention and decision making.


Asunto(s)
Unidades de Cuidado Intensivo Pediátrico , Enfermeras y Enfermeros , Adaptación Psicológica , Niño , Enfermedad Crítica , Humanos , Padres
15.
Artículo en Inglés, Español | MEDLINE | ID: mdl-34226130

RESUMEN

AIM: The main aim of this investigation was to analyse the specificity and sensibility of the COMFORT Behaviour Scale (CBS-S) in assessing grade of pain, sedation, and withdrawal syndrome in paediatric critical care patients. METHOD: An observational, analytical, cross-sectional and multicentre study conducted in Level III Intensive Care Areas of 5 children's university hospitals. Grade of sedation was assessed using the Spanish version of the CBS-S and the Bispectral Index on sedation, once per shift over one day. Grade of withdrawal was determined using the CBS-S and the Withdrawal Assessment Tool-1, once per shift over three days. RESULTS: A total of 261 critically ill paediatric patients with a median age of 5.07 years (P25:0.9-P75:11.7) were included in this study. In terms of the predictive capacity of the CBS-S, it obtained a Receiver Operation Curve of .84 (sensitivity of 81% and specificity of 76%) in relation to pain; .62 (sensitivity of 21% and specificity of 78%) in relation to sedation grade, and .73% (sensitivity of 40% and specificity of 74%) in determining withdrawal syndrome. CONCLUSIONS: The Spanish version of the COMFORT Behaviour Scale could be a useful, sensible and easy scale to assess the degree of pain, sedation and pharmacological withdrawal of critically ill paediatric patients.

16.
Rev. neurol. (Ed. impr.) ; 72(9): 307-312, May 1, 2021. tab
Artículo en Español | IBECS | ID: ibc-227875

RESUMEN

Introducción y objetivo: La pandemia de COVID-19 ha trastornado la actividad hospitalaria, incluyendo la docente. Se describe el cambio de un sistema presencial a otro de sesiones en línea en un servicio de neurología, y se analizan la satisfacción y las opiniones de los usuarios. Material y métodos. Exposición de las medidas adoptadas para pasar a modalidad en línea y análisis de una encuesta entre los participantes. Resultados: Se pasó de tres a dos sesiones semanales, con restricción del público presencial. El público virtual superó al presencial. Contestaron la encuesta 49 participantes, un 51% mujeres, con una media de 40,5 años (rango: 25-65). La satisfacción de los asistentes fue mayor para las sesiones presenciales (8,68) que para las en línea (8,12) (p = 0,006). Existía una correlación inversa significativa entre la edad y la satisfacción con las sesiones en línea (r = –0,37; p = 0,01) que no se daba para las sesiones presenciales. El 75,5% fue partidario de mantener las sesiones virtuales cuando se eliminaran las restricciones de aforo. Una mayoría (87,8%) apoyó sesiones interhospitalarias y recomienda que las autoridades sanitarias faciliten aplicaciones informáticas seguras (53,1%). Conclusiones: La introducción de sesiones virtuales es una medida fácil de implementar en un servicio de neurología, con un alto grado de satisfacción de los usuarios, aunque menor que con las sesiones presenciales. Existen problemas no resueltos respecto al uso de plataformas comerciales y conexión interhospitalaria. Sería recomendable que las autoridades sanitarias y educativas desarrollaran aplicaciones seguras y fomentaran la educación médica en línea.(AU)


Introduction and aim: COVID-19 pandemic has disturbed many hospital activities, including medical education. We describe the switch from in-person didactic sessions to videoconferencing in a Neurology department. We analyse the opinions and satisfaction of participants. Material and methods: Narrative description of the adopted measures; Online survey among participants. Results: One of the three weekly sessions was cancelled, and two switched to videoconferencing. There were more participants online than in the conference hall. 49 users answered the survey, 51% women, mean age 40.5 years (range 25-65). Satisfaction was higher for previous face-to-face meetings (8.68) than for videoconferencing (8.12) (p=0.006). There was a significant inverse correlation between age and satisfaction with virtual sessions (r=-0.37; p=0.01), that was not found for in-person attendance. Most users (75.5%) would prefer to continue with online sessions when the pandemic is over, and 87.8% support inter-hospital remote meetings, but the safety of web platforms is a concern (53.1%). Conclusions: The change from in-person to virtual sessions is an easy measure to implement in a neurology department, with a good degree of satisfaction among users. There are some unsolved problems with the use of commercial web platforms and inter-hospital connection. Most users recommend leadership and support from educational and health authorities.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Satisfacción del Paciente , Rondas de Enseñanza/métodos , Educación Médica/métodos , Educación a Distancia , Neurología/educación , Epidemiología Descriptiva , Estudios Transversales , Encuestas y Cuestionarios
17.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33824050

RESUMEN

AIMS: To determine the grade of sedation in the critically ill paediatric patient using Biespectral Index Sensor (BIS) and to analyse its relationship with sociodemographic and clinical patient variables. METHODS: Observational, analytical, cross-sectional and multicentre study performed from May 2018 to January 2020 in 5 Spanish paediatric critical care units. Sex, age, reason for admission, presence of a chronic pathology, type and number of drugs and length of stay were the sociodemographic and clinical variables registered. Furthermore, the grade of sedation was assessed using BIS, 11per shift over 24hours. RESULTS: A total of 261 paediatric patients, 53.64% of whom were male, with a median age of 1.61 years (0.35-6.55), were included in the study. Of the patients, 70.11% (n=183) were under analgosedation and monitored using the BIS sensor. A median of BIS values of 51.24±14.96 during the morning and 50.75±15.55 during the night were observed. When comparing BIS values and sociodemographic and clinical paediatric variables no statistical significance was detected. CONCLUSIONS: Despite the limitations of the BIS, investigations and the present study show that BIS could be a useful instrument to assess grade of sedation in critically ill paediatric patients. However, further investigations which determine the sociodemographic and clinical variables involved in the grade of paediatric analgosedation, as well as studies that contrast the efficacy of clinical scales like the COMFORT Behaviour Scale-Spanish version, are required.

18.
Rev Neurol ; 72(9): 307-312, 2021 05 01.
Artículo en Español | MEDLINE | ID: mdl-33908617

RESUMEN

INTRODUCTION AND AIM: COVID-19 pandemic has disturbed many hospital activities, including medical education. We describe the switch from in-person didactic sessions to videoconferencing in a Neurology department. We analyse the opinions and satisfaction of participants. MATERIAL AND METHODS: Narrative description of the adopted measures; Online survey among participants. RESULTS: One of the three weekly sessions was cancelled, and two switched to videoconferencing. There were more participants online than in the conference hall. 49 users answered the survey, 51% women, mean age 40.5 years (range 25-65). Satisfaction was higher for previous face-to-face meetings (8.68) than for videoconferencing (8.12) (p=0.006). There was a significant inverse correlation between age and satisfaction with virtual sessions (r=-0.37; p=0.01), that was not found for in-person attendance. Most users (75.5%) would prefer to continue with online sessions when the pandemic is over, and 87.8% support inter-hospital remote meetings, but the safety of web platforms is a concern (53.1%). CONCLUSIONS: The change from in-person to virtual sessions is an easy measure to implement in a neurology department, with a good degree of satisfaction among users. There are some unsolved problems with the use of commercial web platforms and inter-hospital connection. Most users recommend leadership and support from educational and health authorities.


TITLE: Cambio de sesiones docentes presenciales a virtuales durante la pandemia de COVID-19 en un servicio de neurología: descripción del proceso y satisfacción de los usuarios.Introducción y objetivo. La pandemia de COVID-19 ha trastornado la actividad hospitalaria, incluyendo la docente. Se describe el cambio de un sistema presencial a otro de sesiones en línea en un servicio de neurología, y se analizan la satisfacción y las opiniones de los usuarios. Material y métodos. Exposición de las medidas adoptadas para pasar a modalidad en línea y análisis de una encuesta entre los participantes. Resultados. Se pasó de tres a dos sesiones semanales, con restricción del público presencial. El público virtual superó al presencial. Contestaron la encuesta 49 participantes, un 51% mujeres, con una media de 40,5 años (rango: 25-65). La satisfacción de los asistentes fue mayor para las sesiones presenciales (8,68) que para las en línea (8,12) (p = 0,006). Existía una correlación inversa significativa entre la edad y la satisfacción con las sesiones en línea (r = ­0,37; p = 0,01) que no se daba para las sesiones presenciales. El 75,5% fue partidario de mantener las sesiones virtuales cuando se eliminaran las restricciones de aforo. Una mayoría (87,8%) apoyó sesiones interhospitalarias y recomienda que las autoridades sanitarias faciliten aplicaciones informáticas seguras (53,1%). Conclusiones. La introducción de sesiones virtuales es una medida fácil de implementar en un servicio de neurología, con un alto grado de satisfacción de los usuarios, aunque menor que con las sesiones presenciales. Existen problemas no resueltos respecto al uso de plataformas comerciales y conexión interhospitalaria. Sería recomendable que las autoridades sanitarias y educativas desarrollaran aplicaciones seguras y fomentaran la educación médica en línea.


Asunto(s)
COVID-19 , Comportamiento del Consumidor , Educación Médica Continua/métodos , Educación de Postgrado en Medicina/métodos , Neurología/educación , Pandemias , Comunicación por Videoconferencia , Adulto , Anciano , Estudios Transversales , Femenino , Departamentos de Hospitales , Hospitales Universitarios , Humanos , Internado y Residencia , Masculino , Persona de Mediana Edad , Neurólogos/educación , Neurólogos/psicología , Pase de Guardia , Estudiantes de Medicina/psicología , Encuestas y Cuestionarios , Comunicación por Videoconferencia/instrumentación , Comunicación por Videoconferencia/estadística & datos numéricos
19.
Neurologia (Engl Ed) ; 2021 Mar 13.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33726968

RESUMEN

INTRODUCTION: Cerebral amyloid angiopathy-related inflammation (CAA-ri) is an entity characterised by an inflammatory response to ß-amyloid deposition in the walls of cerebral microvessels. METHODS: We conducted a retrospective review of a series of patients with a diagnosis of CAA-ri according to histopathological study findings or clinical-radiological diagnostic criteria. RESULTS: The study included 7 patients (5 men) with a mean age of 79 years. Disease onset was acute or subacute in 6 patients. The most frequent symptoms were cognitive impairment (n = 6), behavioural alterations (n = 5), epileptic seizures (n = 5), focal neurological signs (n = 4), and headache (n = 2). Cerebrospinal fluid was abnormal in 3 patients (lymphocytic pleocytosis and high protein levels). The most frequent MRI findings were microbleeds (n = 7), subcortical white matter hyperintensities on T2-FLAIR sequences (n = 7), and leptomeningeal enhancement (n = 6). Lesions were bilateral in 3 patients and most frequently involved the parieto-occipital region (n = 5). Amyloid PET studies were performed in 2 patients, one of whom showed pathological findings. Two patients underwent brain biopsy, which confirmed diagnosis. All patients received immunosuppressive therapy. An initially favourable clinical-radiological response was observed in all cases, with 2 patients presenting radiological recurrence after treatment withdrawal, with a subsequent improvement after treatment was resumed. CONCLUSIONS: Early diagnosis of CAA-ri is essential: early treatment has been shown to improve prognosis and reduce the risk of recurrence. Although a histopathological study is needed to confirm diagnosis, clinical-radiological criteria enable diagnosis without biopsy.

20.
Eur J Paediatr Dent ; 21(3): 235-237, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32893658

RESUMEN

BACKGROUND: Segmental odontomaxillary dysplasia is an uncommon nonhereditary growth disorder that affects the maxilla, gums and ipsilateral dentition. The disorder is diagnosed mainly based on dental (over-retention of primary teeth, dental agenesis and diastemas) and bone findings (bone sclerosis, irregular trabeculation of immature bone and reduced maxillary sinus). This paper provides a case report. CASE REPORT: A 5-year-old child with skin manifestations including hypertrichosis, facial erythema and pigmented nevus was diagnosed with type II segmental odontomaxillary dysplasia based on clinical, radiographic and histopathological analysis. CONCLUSION: The skin findings can help with the suspicion of segmental odontomaxillary dysplasia, although the definitive diagnosis is typically established by a paediatric dentist based on clinical and radiological findings.


Asunto(s)
Diastema , Odontodisplasia , Enfermedades de la Piel , Preescolar , Humanos , Maxilar , Diente Primario
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