Comprehensive analysis of adverse events associated with transmural use of LAMS in patients with liver cirrhosis: International multicenter study.

Background and study aims Endoscopic ultrasound (EUS)-guided transmural (TM) deployment of lumen-apposing metal stents (LAMS) is considered relatively safe in non-cirrhotic patients and is cautiously offered to cirrhotic patients. Patients and methods This was a retrospective, multicenter, international matched case-control study to study the safety of EUS-guided TM deployment of LAMS in cirrhotic patients. Results Forty-three cirrhotic patients with model for end-stage liver disease score 12.5 ± 5, with 23 having ascites and 16 with varices underwent EUS-guided TM LAMS deployment, including 19 for pancreatic fluid collection (PFC) drainage, 13 gallbladder drainage, six for endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP), three for EDGI, one for endoscopic ultrasound-directed transenteric ERCP, and one postsurgical collection drainage. Technical failure occurred in one LAMS for PFC drainage. Clinical failure was encountered in another PFC. Nine adverse events (AEs) occurred. The most common AE was LAMS migration (3), followed by non-bleeding mucosal erosion (2), delayed bleeding (2), sepsis (1), and anesthesia-related complication (pulseless electrical activity) (1). Most AEs were graded as mild (6), followed by severe (2), and moderate (1); the majority were managed conservatively. On univariable comparison, risk of AE was higher when using a 20 × 10 mm LAMS and the absence of through-the-LAMS plastic stent(s). Conditional logistic regression of matched case-control patients did not show any association between potential predicting factors and occurrence of AEs. Conclusions Our study demonstrated that mainly in patients with Child-Pugh scores A and B cirrhosis and despite the presence of mild-to-moderate ascites in over half of cases, the majority of AEs were mild and could be managed conservatively. Further studies are warranted to verify the safety of LAMS in cirrhotic patients.

Construcción colectiva de un concepto de cuidado humanizado en enfermería / collective building of a concept in nursing humanized care

Objetivo: Construir colectivamente un concepto de cuidado humanizado de enfermería en dos hospitales universitarios de Bogotá D.C. Método: Investigación cualitativa, dialéctica participativa de enfoque histórico-hermenéutico. Se hicieron ocho grupos focales y una entrevista semiestructurada para un total de 57 profesionales de enfermería. La construcción se hizo a partir de un preconcepto basado en el marco teórico, el cual se sometió a discusión entre los participantes. El análisis de los datos se hizo a través de la metodología de análisis de contenido. Resultados: El concepto final incluyó seis categorías: integralidad del sujeto, dignidad y condición humana, principios éticos, reflexión científica, autocuidado y comunicación asertiva y efectiva. Éste reúne elementos fundamentales para la expresión del acto de cuidar, lo que puede sugerir que el atributo de humanización está implícito en el cuidado de enfermería. Conclusión: Se aprecia una concepción operativa y limitada que no evidencia una reflexión trascendente sobre el significado del hombre y la humanización. Los hallazgos de esta investigación sirvieron como base para el diagnóstico situacional del cuidado humanizado en las instituciones objeto de estudio, así como para la búsqueda de alternativas para el fortalecimiento de la humanización como un sello en los servicios de enfermería.

Objective: The aim of this study was build a concept of humanized nursing care a collectively way in two university hospitals in Bogotá DC. Method: It is a participatory dialectic qualitative research with an historical hermeneutic approach. Eight focus groups and one semi-structured interview were made for a total of 57 nurses. The construction was based on pre-concept took from theoretical framework, which was submitted for discussion among participants. The data analysis was done through content analysis methodology. Results: The final concept included six categories: integrity of the subject, dignity and human condition, ethical principles, scientific reflection, and assertive effective communication. It brings key elements for expression of the act of caring which may suggest that the humanized attribute is implicit in nursing care. Conclusion: This operational and limited conception no evidences a transcendent reflection about meaning of human being and humanization. The findings of this research were the basis for one diagnosis of humanized nursing care in institutions under consideration and for the search of alternatives to strengthen the humanization as a label in nursing services.

Violencia sexual y empatia: la danza en contextos terapéuticos / Sexual Violence and Empathy: Dance in Therapeutic Contexts / Violência sexual e empatia: a dança em contextos terapêuticos

El presente artículo tiene como objetivo revisar los temas de violencia sexual, empatia y danza como herramientas terapéuticas en Colombia. Con la intención de asegurar que el material bibliográfico fuese seleccionado por su consistencia y afinidad teórica en estos temas, se revisaron bases de datos como Proquest, Sage, Scielo, PsycINFO, Redalyc, así como las bases de datos de diferentes universidades. Tras haber realizado esta revisión, se encontraron aproximadamente un total de 700 documentos (artículos, libros, capítulos de libros), de los que se seleccionaron 60 referencias, de las cuales 40 fueron artículos de investigación relacionados con el tema. La revisión de este material permitió observar que las terapias corporales son: (a) modalidades que trabajan con poblaciones de edades y diagnósticos variados, entre éstas, suelen trabajar con mujeres y adolescentes sobrevivientes de violencia sexual; (b) la intensidad en tiempo y frecuencia de las intervenciones varía según el encuadre de los tratamientos; y (c) las técnicas utilizadas son puestas en marcha de acuerdo con el punto de partida epistemológico, el enfoque teórico - práctico del terapeuta y las necesidades del sujeto. Respecto al tema de la violencia sexual contra las mujeres, se concluye que es una problemática silenciada, que deja graves secuelas en la salud física y psicológica de las sobrevivientes. Sus efectos se focalizan, entre otros, en la incapacidad de establecer relaciones estables y vínculos empáticos. Las terapias corporales funcionan como herramienta estimuladora de la empatía tanto en ésta como en otras poblaciones.

The purpose of this article is to review issues of sexual violence in Colombia, focusing on empathy and dance as a therapeutic tool. The bibliographical material was selected for its consistency and theoretical affinity with these subjects. We examined the Proquest, Sage, Scielo, PsycINFO, and Redalyc databases, together with databases from universities, and found a total of approximately 700 articles, books, book chapters. 60 of these were selected, and of these, 40 references are research papers pertaining to the matter. Review of the material led to the observation that body therapies are: (a) modalities that work with populations of varied ages and diagnoses, among them women and adolescent survivors of sexual violence; also (b) that the intensity in time and frequency of interventions varies by framing treatments, and that; (c) the techniques used are implemented according to the starting point, epistemological, theoretical and practical approach of the therapist, and the needs of the subject. Regarding the issue of sexual violence against women, it is concluded that this is a problem which has been silenced, and has serious consequences for the physical and psychological health of the survivors. Its effects are focused, among others, on the inability to establish stable and empathic links. Body therapies work as empathy stimulating tools with these and other populations.

O presente artigo tem como escopo revisar os temas de violência sexual, empatia e dança como ferramentas terapêuticas na Colômbia. Com a intenção de assegurar que o material bibliográfico fosse selecionado por sua consistência e afinidade teórica nestes temas, foram revisados bases de dados como Proquest, Sage, Scielo, PsycINFO, Redalyc, assim como as bases de dados de diferentes universidades. Depois de ter feito esta revisão foi achados aproximadamente um total de 700 documentos (artigos, livros, capítulos de livros), dos que foram selecionados 60 referencias, das quais 40 foram artigos de pesquisa relacionados com o tema. A revisão deste material permitiu observar que as terapias corporais são: a) modalidades que trabalham com populações de idades e diagnósticos variados, entre estas, geralmente trabalham com mulheres e adolescentes sobreviventes de violência sexual; b) a intensidade no tempo e frequência das intervenções varia segundo o enquadre dos tratamentos; e c) a técnicas utilizadas são aplicadas de acordo ao ponto de partida epistemológico, o enfoque teórico-prático do terapeuta e as necessidades do sujeito. Respeito ao tema da violência sexual contra as mulheres, conclui-se que é um problema silenciado, que deixa graves sequelas na saúde física e psicológica das sobreviventes. Seus efeitos estão focalizados, entre outros, na incapacidade de estabelecer relações estáveis e vínculos empáticos. As terapias corporais funcionam como ferramenta estimuladora da empatia tanto nesta como em outras populações.

Abuso sexual: síntomas y consecuencias / Sexual abuse: symptoms and consequences

El abuso sexual como delito enmarcado dentro de los contextos de violencia sociopolítica, se reconoce en términos de un evento traumático que deja graves alteraciones en la salud de los sobrevivientes. Las secuelas generadas, tienen alcances devastadores en el curso de lavida de lasvíctimas, comprometiendo su integridad mental, física, y sexual. este artículo, hace una revisión de las principales consecuencias que deja el abuso sexual en las mujeres, a nivel sintomatológico. se exponen también contextos de revictimización y posturas generales respecto al tema en el panorama investigativo(AU)

The sexual abuse like crime framed inside the contexts of violence sociopolítica, admits in terms of a traumatic event that it leaves serious alterations in the health of the survivors. The generated sequels, they have devastating scopes in the course of lavida of lasvíctimas, compromising his mental, physical, and sexual integrity. This article, it does a review of the principal consequences that leaves the sexual abuse in the women, to level sintomatológico. contexts are exposed also of revictimización and general positions with regard to the topic in the panorama investigativo (AU)