RESUMEN
Mucosa-associated lymphoid tissue (MALT) lymphomas are B-cell neoplasms that commonly affect the gastrointestinal (GI) tract, usually the stomach. In most cases, extranodal marginal zone lymphoma (ENMZL) is an indolent disease. Bone marrow involvement is common with MALT lymphoma accompanied by paraproteinemia; such involvement impels disease progression. Here, we present the case of an 82-year-old Hispanic patient with long-standing ENMZL in whom the gastric site responded to antibiotic treatment and Helicobacter pylori eradication, but the disease progressed over the years, with a biclonal gammopathy and bone marrow involvement with marked plasmacytic differentiation. In view of this, we suggest the routine evaluation of paraprotein in patients with ENMZL.
Asunto(s)
Cromosomas Humanos Par 11 , Linfoma de Células B de la Zona Marginal , Paraproteinemias/diagnóstico , Neoplasias Gástricas , Anciano de 80 o más Años , Médula Ósea/patología , Enfermedades de la Médula Ósea/patología , Cromosomas Humanos Par 11/genética , Fatiga/diagnóstico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Cadenas lambda de Inmunoglobulina/sangre , Neoplasias Pulmonares/diagnóstico por imagen , Linfoma de Células B de la Zona Marginal/sangre , Linfoma de Células B de la Zona Marginal/tratamiento farmacológico , Linfoma de Células B de la Zona Marginal/genética , Linfoma de Células B de la Zona Marginal/patología , Masculino , Mieloma Múltiple/diagnóstico , Proteínas de Fusión Oncogénica/genética , Neoplasias Gástricas/sangre , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/genética , Neoplasias Gástricas/patología , Trisomía/genéticaRESUMEN
AIM: To conduct a scoping review to examine and map the interventions proposed for the improvement of the working conditions of nursing staff in acute care hospitals. BACKGROUND: The Registered Nurse Forecasting (RN4CAST) project and other studies have determined the impact that the nursing staff has on the quality of care. The nursing staff's higher levels of burnout, job dissatisfaction and negative perception of the quality of care provided caused worse health outcomes. METHODS: A scoping review was carried out. By searching in SCOPUS, PubMed, CINAHL, Cochrane, Dialnet and in the grey literature, 705 potentially relevant papers were identified. The final analysis included 21 papers and three grey documents. RESULTS: The studies analysed proposed interventions at the macro-management, meso-management and micro-management levels, although the interventions at the macro- and meso-levels produce better staff outcomes. CONCLUSIONS: The findings of this review can be applied to management at different levels: measures to improve the patient-nurse ratio at the macro-management level, the horizontal hierarchies at the meso-management level, the mind-body techniques at the micro-management level. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers and leaders should implement interventions at different organisational levels to improve the working conditions of the nursing staff and other health outcomes.