Predictive Factors for Anxiety during Blood Sampling and Insertion of Peripheral Intravenous Catheters in Paediatric Patients in Spain.

INTRODUCTION: Invasive procedures for diagnosis purposes such as venepuncture and peripheral venous catheter insertion are painful procedures that cause great stress for paediatric patients. The objective of this study is to find out the factors that have an impact on the level of anxiety experienced by children undertaken these procedures. DESIGN AND METHODS: Prospective study, 359 children between 2 and 15 years old were included, treated in a tertiary reference hospital in the region of Navarra (Spain). The impact of the variables recorded was analysed using a regressive analysis, the Wong-Baker and FLACC scales were used to measure the level of pain and the PACBIS scale to measure the level of stress and anxiety. RESULTS: The average age of the participants was 7.93 years (SD: 4.04), with 51.8% (n = 186) boys and 48.2% (n = 173) girls. The mean value of pain recorded was 4.43 (SD:3.10). 45.7% (n = 123) of the venepuncture techniques was associated with minimum level of anxiety, including 11.1% of intravenous catheterization. Variables determining the anxiety has been detected such as age, sex, level of pain, parental conduct and time spent on the procedure. CONCLUSIONS: Paediatric patients experience high levels of anxiety when undergoing painful procedures which are conditioned by multifactorial reasons. The increase in stress is directly related to the older age (>6 years old) of the patient, and statistically significant by the female gender, the longer duration of the technique and the parental block. PRACTICE IMPLICATIONS: Healthcare professionals should work on some of the variables and apply measures aimed to mitigate anxiety levels. For example, reducing the duration of the procedure, training parents, and distracting techniques.

[Effectiveness of nursing interventions in the control of type 2 diabetes mellitus].

BACKGROUND: To analyze whether nursing interventions classified according to NIC taxonomy and applied to patients with type 2 diabetes mellitus (T2DM), showing the NANDA diagnoses "Willingness to improve your own health management", are related to better achievement of T2DM control. METHODS: Cross-sectional study conducted on 721 patients in Primary Care whose data were obtained from their electronic clinical record. The control of parameters such as hemoglobin-glycosylated (HbA1c), LDL-cholesterol and body mass index (BMI) was related to NIC interventions performed, particularly to those recommended for management of T2DM. RESULTS: One hundred and thirty-seven NIC interventions were performed on 2,401 occasions, 1,714 of which (71.4%) were interventions recommended for management of T2DM. Of these, 41.2% belonged to Behavioral domain, while Surveillance was the most frequent intervention (25.4%). Control of both HbA1c and LDL-cholesterol was achieved in more than 50% of cases, but BMI only was achieved in 13.6%. NIC interventions were more frequently performed on patients with controlled parameters, especially on nine of them; two interventions were negatively related to control of BMI. CONCLUSION: We have observed that with a higher incidence in the application of the NIC included in the recommendations of the clinical practice guidelines for T2DM, better health results are obtained.

Efectividad de las intervenciones enfermeras en el control de la diabetes mellitus tipo 2 / Effectiveness of nursing interventions in the control of type 2 diabetes mellitus

FUNDAMENTO: Analizar si las intervenciones de enfermería clasificadas mediante la taxonomía NIC y aplicadas a pacientes con diabetes mellitus tipo 2 (DM2) que cuenten con el diagnóstico de enfermería NANDA Disposición para mejorar la gestión de su propia salud se relacionan con la consecución de un mejor control de la enfermedad. MÉTODO: Estudio trasversal con 721 pacientes de Atención Primaria cuyos datos se obtuvieron de la historia clínica electrónica. Se analizó la relación del estado controlado o no de los parámetros hemoglobina glicosilada (HbA1c), colesterol-LDL (Col-LDL) e índice de masa corporal (IMC), con las intervenciones NIC realizadas, especialmente las correspondientes a recomendaciones para el manejo de la DM2. RESULTADOS: Se realizaron 137 tipos de intervenciones de enfermería NIC en 2.401 ocasiones, de las cuales 1.714 (71,4%) fueron intervenciones recomendadas para la DM2, un 41,2% ellas pertenecientes al dominio Conductual, siendo Vigilancia la intervención más frecuente (25,4%). La consecución de objetivos fue superior al 50% para HbA1c y Col-LDL y del 13,6% para el IMC. Las intervenciones NIC fueron más frecuentes en los pacientes con parámetros controlados, especialmente nueve de ellas; dos presentaron una relación negativa con el control del IMC. CONCLUSIONES: A mayor aplicación de las NIC recogidas en las recomendaciones de las guías de práctica clínica para la DM2 se ha observado mayor consecución de objetivos de control y mejores resultados en salud

BACKGROUND: To analyze whether nursing interventions classified according to NIC taxonomy and applied to patients with type 2 diabetes mellitus (T2DM), showing the NANDA diagnoses "Willingness to improve your own health management", are related to better achievement of T2DM control. METHODS: Cross-sectional study conducted on 721 patients in Primary Care whose data were obtained from their electronic clinical record. The control of parameters such as hemoglobin-glycosylated (HbA1c), LDL-cholesterol and body mass index (BMI) was related to NIC interventions performed, particularly to those recommended for management of T2DM. RESULTS: One hundred and thirty-seven NIC interventions were performed on 2,401 occasions, 1,714 of which (71.4%) were interventions recommended for management of T2DM. Of these, 41.2% belonged to Behavioral domain, while Surveillance was the most frequent intervention (25.4%). Control of both HbA1c and LDL-cholesterol was achieved in more than 50% of cases, but BMI only was achieved in 13.6%. NIC interventions were more frequently performed on patients with controlled parameters, especially on nine of them; two interventions were negatively related to control of BMI. CONCLUSION: We have observed that with a higher incidence in the application of the NIC included in the recommendations of the clinical practice guidelines for T2DM, better health results are obtained

[Single metastasis of renal adenocarcinoma in contralateral adrenal gland]. / Metástasis única de adenocarcinoma renal en suprarrenal contralateral.

Presentation of a 63-year old female patient with single metastasis in right suprarenal gland from a simultaneous contralateral renal adenocarcinoma. The approach used was left nephrectomy and right suprarenalectomy. Two years after surgery, the patient is alive and shows no evidence of relapse. The extreme rarity of this finding is emphasized, and clinical, diagnostic, therapeutic and prognostic aspects are commented after reviewing the relevant literature.

[Laryngeal and hypopharyngeal liposarcoma. Report of a case and literature review]. / Liposarcoma de laringe e hipofaringe. Presentación de un caso y revisión de la literatura.

Liposarcoma is the second sarcoma of soft tissues more frequent in adult-age. Its localisation in head and neck is odd. The majority of liposarcoma, of this sitting, take its origin from soft tissues of the neck, being unusual primary liposarcoma from larynx and hypolarynx. Presentation of one case of liposarcoma of the larynx and hypopharynx and review of the opportune literature.

[Health habits of health professionals]. / Hábitos de salud de los profesionales de enfermería.

The conduct of medical professionals is an important educational point of reference for the many people who see and know them. Nurses and other medical workers are often role models in which their daily health habits may be imitated by their patients, family of friends. With this in mind a study, based on a previously published work in the United States (Health Practices of Nursing Students), was performed to determine, first, if the daily habits of nurses are indeed healthy and adequate to communicate a salubrious lifestyle; second, to see if this group considers themselves capable and responsible for changing those unsanitary habits that they do have. Results of the surveys of 125 subject nurses from the University of Navarra indicate that there is a great amount of consciousness regarding the danger of most unsanitary habits and the need to avoid them, although many of them remain firmly entrenched in their daily lives. The percentage of nurses who felt capable or responsible for changing unhealthy practices was low (67.5%).

[Prevalence of epidemic outbreak of tularemia in the Hospital Universitario Río Hortega (Spain) in the year 2007]. / Situación del brote epidémico de tularemia durante el año 2007 en el Hospital Universitario Río Hortega de Valladolid.

INTRODUCTION: This present research study presents the analytic results of an outbreak of tularemia (Francisella tularensis) that occurred in the Northwest areas of Castilla y León in Northern Spain in late June 2007. PATIENTS AND METHODS: Serum was obtained from 302 patients from a West Valladolid health area, attended in the University Hospital of Río Hortega of the Castilla y León Health Care Service, with suspicion of tularemia. A tube agglutination test was performed in all of them to detect anti-F. tularensis antibodies. RESULTS: Anti-F. tularensis antibodies were detected in 59 (19%) of reported cases (302 sera). The most frequent clinical presentations of the disease suggest that the main transmission pathway was through inhalation of the bacteria. CONCLUSIONS: When the 2007 outbreak of human tularemia was compared with that which occurred in 1997, we observed a lower number of positive cases in the recent outbreak as well as a difference in the transmission pathway and predominant form of clinical presentation of the disease.

[Simplified Ramírez urethropexy in the treatment of genuine stress urinary incontinence in women. Multicenter study of clinical and urodynamic results]. / Uretropexia simplificada de Ramírez en el tratamiento de la incontinencia urinaria de esfuerzo genuina en la mujer. Estudio multicéntrico sobre los resultados clínicos y urodinámicos.

OBJECTIVES: To evaluate the clinical and urodynamic data of a multicenter study on female urinary stress incontinence undergoing surgical repair with the Ramírez simplified urethropexy. METHODS: Clinical, urodynamic and videocystographic data were analyzed in a multicenter series of 340 female patients with urinary stress incontinence (mean age 51.7 +/- 9.7 years) before and after the Ramírez urethropexy technique (mean follow-up 21.7 months). RESULTS: Post surgical urinary continence was 78.4%. Cystocele repair was demonstrated in 57.7%. Urge incontinence decreased in 17.1%. Daytime frequency statistically significantly decreased in 19%. Urinary obstructive symptoms increased in 19.3%. Bladder instability significantly decreased posturethropexy. Peak urinary flow rate and mean urinary flow rate diminished in 65% and 59%, respectively. Postvoiding residual urine increased significantly. No statistical correlation between posturethropexy continence and videocystographic bladder neck morphology was observed. CONCLUSIONS: The clinical and urodynamic data obtained in our series indicate that the Ramírez urethropexy technique, a simple and fast procedure, may be considered an alternative treatment in female urinary stress incontinence.

Situación del brote epidémico de tularemia durante el año 2007 en el Hospital Universitario Río Hortega de Valladolid / Prevalence of epidemic outbreak of tularemia in the Hospital Universitario Río Hortega (Spain) in the year 2007

Introducción: El presente trabajo de investigación es relativo a los resultados analíticos sobre el brote de tularemia aparecido en poblaciones del noroeste de Castilla y León en el verano de 2007. Pacientes y métodos: Se obtuvieron 302 sueros de residentes en el Área de Salud Oeste de Valladolid, atendidos en el Hospital Universitario Río Hortega de SACYL. A todos ellos se les realizó una prueba de aglutinación en tubo para detectar anticuerpos anti-Fancisella tularensis. Resultados: Se detectaron anticuerpos anti-F. tularensis en 59 (19%) de los 302 sueros estudiados. Las formas clínicas más frecuentes de presentación de la enfermedad sugieren la vía inhalatoria como puerta de entrada del germen. Conclusiones: Al comparar el actual brote de tularemia humana con el de finales de 1997 observamos un menor número de casos positivos y diferencias en cuanto a vía de transmission y forma clínica de presentación predominante (AU)

Introduction: This present research study presents the analytic results of an outbreak of tularemia (Francisella tularensis) that occurred in the Northwest areas of Castilla y León in Northern Spain in late June 2007. Patients and methods: Serum was obtained from 302 patients from a West Valladolid health area, attended in the University Hospital of Río Hortega of the Castilla y León Health Care Service, with suspicion of tularemia. A tube agglutination test was performed in all of them to detect anti-F. tularensisantibodies. Results: Anti-F. tularensis antibodies were detected in 59 (19%) of reported cases (302 sera). The most frequent clinical presentations of the disease suggest that the main transmission pathway was through inhalation of the bacteria. Conclusions: When the 2007 outbreak of human tularemia was compared with that which occurred in 1997, we observed a lower number of positive cases in the recent outbreak as well as a difference in the transmission pathway and predominant form of clinical presentation of the disease (AU)