Opinions of nurses regarding conscientious objection.

BACKGROUND: In the last decades, there have been important developments in the scientific and technological areas of healthcare. On certain occasions this provokes conflict between the patients' rights and the values of healthcare professionals which brings about, within this clinical relationship, the problem of conscientious objection. AIMS: To learn the opinions that the Nurses of the Madrid Autonomous Community have regarding conscientious objection. RESEARCH DESIGN: Cross-cutting descriptive study. PARTICIPANTS AND RESEARCH CONTEXT: The nurses of 9 hospitals and 12 Health Centers in the Madrid Autonomous Community. The study was done by means of an auto completed anonymous questionnaire. The variables studied were social-demographical and their opinions about conscientious objections. ETHICAL CONSIDERATIONS: The study was approved by the Ethical Community of Clinical Research of the University Hospital Príncipe de Asturias. Participants were assured of maximum confidentiality and anonymity. FINDINGS: A total of 421 nurses answered the questionnaire. In total, 55.6% of the nurses confirmed they were religious believers, and 64.3% declared having poor knowledge regarding conscientious objection. The matters that caused the greatest objections were voluntary abortions, genetic embryo selection, refusal of blood transfusions, and therapy refusal. DISCUSSION: Different authors state that the most significant cases of conscientious objections for health professionals are those regarding carrying out or assisting in abortions, euthanasia, the practice of assisted reproduction and, finally, the prescription and dispensing of the morning-after pill. In our study, the most significant cases in which the nurses would declare conscientious objections would be the refusal to accept treatment, the selection of embryos after genetic diagnosis preimplantation, the patient's refusal to receive blood transfusions due to religious reasons and pregnant women's request for voluntary abortions within the first 14 weeks. CONCLUSION: Nurses' religious beliefs influence their opinions regarding conscientious objection. The nurses who declare themselves as religious believers object in a higher percentage than those without religious beliefs.

Particle-based optical sensing of intracellular ions at the example of calcium - what are the experimental pitfalls?

Colloidal particles with fluorescence read-out are commonly used as sensors for the quantitative determination of ions. Calcium, for example, is a biologically highly relevant ion in signaling, and thus knowledge of its spatio-temporal distribution inside cells would offer important experimental data. However, the use of particle-based intracellular sensors for ion detection is not straightforward. Important associated problems involve delivery and intracellular location of particle-based fluorophores, crosstalk of the fluorescence read-out with pH, and spectral overlap of the emission spectra of different fluorophores. These potential problems are outlined and discussed here with selected experimental examples. Potential solutions are discussed and form a guideline for particle-based intracellular imaging of ions.

[Cardiac disorders in young women with anorexia nervosa]. / Alteraciones cardiológicas en mujeres adolescentes con anorexia nerviosa.

INTRODUCTION AND OBJECTIVES: The objective of this study was to compare heart abnormalities in young women with anorexia nervosa and in a control group of the same age and sex. Patients and method. We report a matched case-control study of 30 adolescents with anorexia nervosa and 30 healthy women of the same age with normal weight. An electrocardiogram and echocardiogram were done. Heart parameters were measured on the electrocardiographic tracings, and QT dispersion was defined as the difference between maximum QT and minimum QT in any of the 12 leads. Diameter, mass and left ventricular mass index were measured. RESULTS: QT and corrected QT intervals were significantly greater in patients with anorexia nervosa than in the control group. QT dispersion and corrected QT dispersion were significantly greater in anorexia nervosa than in the control group (QTd, 59.3 23.0 vs 38.4 8.0 ms; p = 0.000; QTcd, 56.5 24.2 vs. 40.3 21.8 ms; p = 0.011). Left ventricular mass was significantly lower in young women with anorexia nervosa. We found a significant relationship between body mass index and left ventricular mass index, and between the former and corrected QT dispersion. CONCLUSIONS: Adolescents with anorexia nervosa show significant cardiac disorders in comparison to healthy women of the same age. This finding may be a useful indicator of the risk of arrhythmia and sudden death in patients with anorexia nervosa.

Mucogingival therapy to treat implant fenestration in the esthetic zone: a case report after 2 year follow up.

Soft tissue fenestration in implants is considered not only as a situation that could negatively influence the long-term stability of the implant, but also creates an esthetic problem when it occurs in the visible area of the mouth. This article describes the resolution of a case that presented a vestibular fenestration of an osseointegrated implant placed to substitute the upper right incisor, which does not respect the recommendations of ideal three-dimensional position in a young patient with a high smile line. The case was treated using two mucogingival surgical techniques to avoid a more invasive approach. A prosthetic immediate final abutment was inserted in the day of the second surgery. The fenestration was successfully covered and 2 years later it remains stable. In this article, the details about the treatment are described.

Stenotrophomonas maltophilia: una causa poco frecuente de peritonitis en diálisis peritoneal / Stenotrophomonas maltophilia: A rare cause of peritonitis in capd patients

No disponible

Peritonitis por Eikenella corrodens y Prevotella oralis en pacientes en diálisis peritoneal / Eikenella corrodens and Prevotella oralis peritonitis in patients on peritoneal dialysis

No disponible

Antecedentes históricos del objeto de investigación de las tesis de doctorado en ciencias pedagógicas para aspirantes de ciencias médicas / Historical background of research object when making a Doctoral Dissertation in Pedagogical Sciences for persons who wish to study Medical Sciences

El presente artículo va dirigido a los profesionales de las ciencias médicas que realizan investigaciones de corte pedagógico para alcanzar el grado científico de Doctor en Ciencias Pedagógicas. Se parte de lo necesario que resulta escudriñar el objeto y campo de estudio en el recorrido histórico de ambos para poder determinar las tendencias de su desarrollo en el tiempo que ha mediado entre uno y otro. Se trabajan las categorías pasado, presente y futuro en la periodización, que en un proceso pedagógico durante su devenir histórico, ayuda a comprenderlo y facilita revelar las tendencias inherentes a este y, por ende, brinda al investigador la posibilidad de realizar síntesis científica(AU)

This article is addressed to Medical Sciences professionals who carry out pedagogical research in order to achieve the scientific degree of Doctor in Pedagogical Sciences. It is highly necessary to start from the object and study field examination in the historical path of both so as to determine the tendency of its development in the period of time between one and other. Past, present, and future categories are used in the periodization which, in a pedagogical process during its historical evolution, helps to understand it and allows revealing the tendencies inherent in it. Thus, the researcher has the possibility to perform the scientific synthesis(AU)

Antecedentes históricos del objeto de investigación de las tesis de doctorado en ciencias pedagógicas para aspirantes de ciencias médicas / Historical background of research object when making a Doctoral Dissertation in Pedagogical Sciences for persons who wish to study Medical Sciences

El presente artículo va dirigido a los profesionales de las ciencias médicas que realizan investigaciones de corte pedagógico para alcanzar el grado científico de Doctor en Ciencias Pedagógicas. Se parte de lo necesario que resulta escudriñar el objeto y campo de estudio en el recorrido histórico de ambos para poder determinar las tendencias de su desarrollo en el tiempo que ha mediado entre uno y otro. Se trabajan las categorías pasado, presente y futuro en la periodización, que en un proceso pedagógico durante su devenir histórico, ayuda a comprenderlo y facilita revelar las tendencias inherentes a este y, por ende, brinda al investigador la posibilidad de realizar síntesis científica.

This article is addressed to Medical Sciences professionals who carry out pedagogical research in order to achieve the scientific degree of Doctor in Pedagogical Sciences. It is highly necessary to start from the object and study field examination in the historical path of both so as to determine the tendency of its development in the period of time between one and other. Past, present, and future categories are used in the periodization which, in a pedagogical process during its historical evolution, helps to understand it and allows revealing the tendencies inherent in it. Thus, the researcher has the possibility to perform the scientific synthesis.

Factores de riesgo de intento suicida en adolescentes / Risk factors of suicide attempt in adolescents

Se realizó un estudio de casos y controles para identificar los factores de riesgo asociados al intento suicida en 162 adolescentes del área de salud perteneciente al Policlínico Docente Julián Grimau García de Santiago de Cuba en el bienio 2003-2004, de los cuales 54 habían intentado contra su vida y 108 no tenían antecedentes de ese comportamiento (estos últimos seleccionados con una relación de 1:2). Se calcularon la tasa relativa (en inglés odds ratio) y el riesgo atribuible porcentual en los individuos expuestos, así como también la significación o no mediante la prueba de Ji al cuadrado, con un nivel de confiabilidad de 95 por ciento. Entre las principales variables analizadas figuraron: edad, sexo, ocupación, escolaridad, antecedentes patológicos familiares y personales, tipo de familia y otros. Los factores de riesgo comúnmente asociados a la conducta suicida fueron: los antecedentes patológicos familiares y los conflictos (familiares, económicos y docentes), por lo cual se estimó que la intervención directa sobre las familias, a cargo del equipo sanitario y otro personal capacitado para ello, será un eslabón estratégico en el control y la disminución de este problema de salud(AU)

A study of cases and controls to identify the risk factors associated to suicide attempt was carried out in 162 adolescents of the health area belonging to Julián Grimau García Teaching Polyclinic in Santiago de Cuba in the biennium 2003-2004, of which 54 had attempted against their lives and 108 didn't have history of that behavior (the latter selected with a ratio of 1:2). There was an estimate of the relative rate (odds ratio in English) and the percentage attributable risk in the exposed individuals, as well as the significance or not by means of the chi-square test, with a confidence level of 95 per cent. Among the main variables analyzed there were: age, sex, occupation, educational background, familiar and personal pathological history, kind of family and others. The risk factors commonly associated to the suicidal behavior were: the family pathological history and the conflicts (familiar, economic and teaching conflicts), that is why it was considered that the direct intervention on the families, by the sanitary equipment and other staff qualified for this, will be a strategic link in the control and the decrease of this health problem(AU)

Factores de riesgo de intento suicida en adolescentes / Risk factors of suicide attempt in adolescents

Se realizó un estudio de casos y controles para identificar los factores de riesgo asociados al intento suicida en 162 adolescentes del área de salud perteneciente al Policlínico Docente Julián Grimau García de Santiago de Cuba en el bienio 2003-2004, de los cuales 54 habían intentado contra su vida y 108 no tenían antecedentes de ese comportamiento (estos últimos seleccionados con una relación de 1:2). Se calcularon la tasa relativa (en inglés odds ratio) y el riesgo atribuible porcentual en los individuos expuestos, así como también la significación o no mediante la prueba de Ji al cuadrado, con un nivel de confiabilidad de 95 por ciento. Entre las principales variables analizadas figuraron: edad, sexo, ocupación, escolaridad, antecedentes patológicos familiares y personales, tipo de familia y otros. Los factores de riesgo comúnmente asociados a la conducta suicida fueron: los antecedentes patológicos familiares y los conflictos (familiares, económicos y docentes), por lo cual se estimó que la intervención directa sobre las familias, a cargo del equipo sanitario y otro personal capacitado para ello, será un eslabón estratégico en el control y la disminución de este problema de salud.

A study of cases and controls to identify the risk factors associated to suicide attempt was carried out in 162 adolescents of the health area belonging to Julián Grimau García Teaching Polyclinic in Santiago de Cuba in the biennium 2003-2004, of which 54 had attempted against their lives and 108 didn't have history of that behavior (the latter selected with a ratio of 1:2). There was an estimate of the relative rate (odds ratio in English) and the percentage attributable risk in the exposed individuals, as well as the significance or not by means of the chi-square test, with a confidence level of 95 per cent. Among the main variables analyzed there were: age, sex, occupation, educational background, familiar and personal pathological history, kind of family and others. The risk factors commonly associated to the suicidal behavior were: the family pathological history and the conflicts (familiar, economic and teaching conflicts), that is why it was considered that the direct intervention on the families, by the sanitary equipment and other staff qualified for this, will be a strategic link in the control and the decrease of this health problem.

Electrocardiographic and echocardiographic findings in malnourished children.

OBJECTIVE: To compare heart abnormalities in a group of malnourished children with a control group and to describe their predictive variables. METHODS: Thirty children with malnutrition were matched with thirty healthy children. Anthropometry, plasma levels of albumin and electrolytes were determined. Among others, corrected QT interval (QTc) and QT dispersion (QTd: difference between the maximum and the minimum QT) were measured in 12-lead electrocardiogram; and left ventricular mass (LVm) and left ventricular mass index (LVmi) were measured by echocardiography. Regression analyses were performed with cardiac findings as dependent variables and anthropometric and biochemical data as independent variables. RESULTS: Plasma levels of albumin, potassium and calcium were lower in malnourished children. QTc and QTd were significantly greater in patients with malnutrition than in controls (QTc: 445.9 +/- 31.4 vs. 400.9 +/- 17.7 ms, p = 0.000; QTd: 76.4 +/- 34.1 vs. 47.9 +/- 10.2 ms, p = 0.000). LVm and LVmi were significantly lower in malnourished children (LVm: 55.3 +/- 10.3 vs. 71.4 +/- 6.9 g, p = 0.000; LVmi: 46.5 +/- 6.6 vs. 60.5 +/- 4.9 g/m2, p = 0.000). The body mass index (kg/m2) was the most powerful predictor of the variability in QTc (39.1%), LVm (48.1%) and LVmi (51.2%). CONCLUSIONS: Important electrocardiographic and echocardiographic abnormalities have been found in malnourished children associated with their nutritional status. Special precaution must be taken about the possibility of occurrence of arrhythmias and sudden death related with malnutrition.

Cardiac findings in adolescents with anorexia nervosa at diagnosis and after weight restoration.

UNLABELLED: The aim of this study was to compare heart abnormalities in a group of young women with anorexia nervosa at diagnosis and after weight restoration. A total of 40 young women with anorexia nervosa were evaluated, at baseline, (diagnosis) and follow-up (9 to 18 months later) and matched with 40 healthy women of the same age and of normal weight. QT interval was measured from surface electrocardiograms. QT dispersion was defined as the difference between maximum QT and minimum QT occurring in any of the 12 leads. Left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular mass, left ventricular mass index, cardiac output, fractional shortening and fractional ejection, were measured by echocardiography. In anorexia nervosa patients, corrected QT interval and QT dispersion, significantly decreased from baseline to follow-up. Left ventricular end-diastolic dimension, left ventricular mass index, and cardiac output, in anorexia nervosa were significantly lower at diagnosis than at follow-up after weight restoration. CONCLUSION: Adolescents with anorexia nervosa have significant functional and structural cardiac abnormalities; weight gain was associated with improvement. Appropriate attention should be paid to cardiac involvement.

Empleo de comprimidos de manzanilla en ancianos con afecciones digestivas / Chamomile tablets use in old men with digestive affections

Se realiza un estudio analítico, transversal y prospectivo, con el objetivo de estudiar el efecto de los comprimidos de manzanilla (Manzanisan) producidos en los Laboratorios Farmacéuticos de Oriente, como tratamiento sintomático, sobre el aparato digestivo en un grupo de ancianos con diversas enfermedades de dicho aparato. Los pacientes son procedentes de la comunidad y vinculados a la consulta externa de geriatría del Policlínico de Especialidades Saturnino Lora de Santiago de Cuba. Se comprueba el beneficio de su uso en los pacientes estudiados y que su aplicación no tuvo efectos indeseables. Se concluye que la manzanilla, (Matricaria recutita L) en su presentación de comprimidos, es útil para el tratamiento de algunos síntomas del tracto digestivo en pacientes ancianos y se recomienda la extensión del estudio a grupos más numerosos de pacientes mayores para lograr resultados estadísticamente más significativos(AU)

Programa de diagnóstico y prevención de malformaciones congénitas en la provincia de Santiago de Cuba / Program of diagnosis and prevention the congenital malformations in Santiago de Cuba Province

INTRODUCCIÓN: La aplicación del Programa Nacional de Diagnóstico y Prevención de Malformaciones Congénitas en la provincia de Santiago de Cuba ha propiciado avances en su prevención primaria y diagnóstico prenatal, que han posibilitado la reducción de la mortalidad infantil, aunque aún se mantienen entre las 3 primeras causas de muerte en menores de 15 años, sobre todo por malformaciones prevenibles, teniendo en cuenta el desarrollo científico y tecnológico en la Cuba de hoy. OBJETIVO: Identificar algunos aspectos que influyeron en la ejecución del Programa en la provincia. MÉTODOS: Se realizó un estudio descriptivo durante 1997, catalogado como una investigación sobre servicios de salud, para lo cual se escogió de forma opinática un grupo de 34 expertos de diferentes especialidades médicas relacionadas con el funcionamiento del Programa, utilizando la técnica de la entrevista en profundidad. RESULTADOS: Fueron señaladas deficiencias referentes a la prevención primaria y diagnóstico prenatal, tales como: de competencia y desempeño, deterioro de recursos materiales, falta de sistematicidad en el control administrativo del Programa e insuficiente educación de la población sobre aspectos relacionados con la genética. CONCLUSIONES: La solución de los problemas detectados, especialmente la capacitación del personal médico y la educación sanitaria dirigida a la comunidad, es esencial para mejorar los resultados y reducir la contribución de las malformaciones a la mortalidad infantil en el territorio(AU)

Experiencia en gestión del riesgo en 2 unidades de hospitalización del Hospital Monte Naranco de Oviedo / Experience of risk management in 2 admission units in the Hospital Monte Naranco in Oviedo (Spain)

No disponible

Alteraciones cardiológicas, potencialmente letales, en adolescentes con anorexia nerviosa / Potentially lethal cardiology disorders in adolescents with anorexia nervosa

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Alteraciones cardiológicas en mujeres adolescentes con anorexia nerviosa / Cardiac disorders in young women with anorexia nervosa

Introducción y objetivos. El objetivo de este estudio es comparar las alteraciones cardiológicas de mujeres adolescentes con anorexia nerviosa con un grupo control de la misma edad y sexo. Pacientes y método. Se trata de un estudio de casos y controles apareado en 30 mujeres adolescentes con anorexia nerviosa y 30 controles sanas de la misma edad y peso normal. Se les realizó electrocardiograma y ecocardiograma. Los parámetros cardiológicos fueron medidos sobre la superficie de los electrocardiogramas y la dispersión de QT fue definida como la diferencia entre el máximo y el mínimo QT de las 12 derivaciones. Se cuantificó el diámetro y la masa y el índice masa del ventrículo izquierdo. Resultados. Los intervalos QT y QT corregidos fueron significativamente mayores en pacientes con anorexia nerviosa que en el grupo control. Las dispersiones del intervalo QT y del intervalo QT corregido fueron significativamente mayores en la anorexia nerviosa que en el grupo control (QTd, 59,3 ñ 23,0 frente a 38,4 ñ 8,0 ms; p = 0,000; QTcd, 56,5 ñ 24,2 frente a 40,3 ñ 21,8 ms; p = 0,011). La masa del ventrículo izquierdo fue significativamente menor en las mujeres con anorexia nerviosa. Existe una correlación significativa entre el índice de masa corporal y el índice de masa del ventrículo izquierdo y la dispersión del intervalo QT corregido. Conclusiones. Las adolescentes con anorexia nerviosa presentan alteraciones cardiológicas significativas en relación con mujeres sanas de la misma edad. Dichos parámetros pueden ser indicadores útiles de riesgo de arritmia y muerte súbita en pacientes con anorexia nerviosa (AU)