Intervencionismo coronario / Coronary interventionism

The scientific and technological advances have allowed that to the patients with acute coronary syndromes, offer an alternative to them of treatment in the rooms of hemodynamic by means of coronary interventionism, using catheter compliante or noncompliante ball, ball of cut, implanting stent nonliberating and liberating of drugs, avoiding to them the risk of a greater surgery to place venous or arterial bridges in the affected zone; receiving therefore the benefit of a percutaneous coronary revascularization, by means of a procedure less aggressive than the surgery without the risks of traqueal intubation, thoracotomy, saphenectomy, cardioplegia, drainages, minor risk of bled and infection, short period of time of hospitalization, decrease of the costs and the time for its restoration to the daily life. During the development of coronary interventionism personal professional participates: interventionist, anesthesiologist cardiologist, nurse and technician in Rx. The coronary interventionist procedure is a common procedure but of high risk, since the manipulation of the catheters and guides is direct in the light of the glass to treat; only in the year of 1997 a million procedures were made at world-wide level, without a doubt some, this has been increased enormously, demanding so the infirmary professional that toils in the room of hemodynamic maintains updated in the different techniques from coronary interventionism, as well as to know the diverse instruments and devices that the biomedical industry develops day to day to provide a free suitable attention of risk.

[Coronary interventionism]. / Intervencionismo coronario.

The scientific and technological advances have allowed that to the patients with acute coronary syndromes, offer an alternative to them of treatment in the rooms of hemodynamic by means of coronary interventionism, using catheter compliante or noncompliante ball, ball of cut, implanting stent nonliberating and liberating of drugs, avoiding to them the risk of a greater surgery to place venous or arterial bridges in the affected zone; receiving therefore the benefit of a percutaneous coronary revascularization, by means of a procedure less aggressive than the surgery without the risks of traqueal intubation, thoracotomy, saphenectomy, cardioplegia, drainages, minor risk of bled and infection, short period of time of hospitalization, decrease of the costs and the time for its restoration to the daily life. During the development of coronary interventionism personal professional participates: interventionist, anesthesiologist cardiologist, nurse and technician in Rx. The coronary interventionist procedure is a common procedure but of high risk, since the manipulation of the catheters and guides is direct in the light of the glass to treat; only in the year of 1997 a million procedures were made at world-wide level, without a doubt some, this has been increased enormously, demanding so the infirmary professional that toils in the room of hemodynamic maintains updated in the different techniques from coronary interventionism, as well as to know the diverse instruments and devices that the biomedical industry develops day to day to provide a free suitable attention of risk.

Diagnósticos de enfermería en el cuidado del niño con insuficiencia cardiaca en estado crítico / Nursing diagnostics for nursing care of children with cardiac insufficiency

Las cardiopatías congénitas del corazón constituyen 90% de las causas de falla cardiaca y 5°lugar a nivel nacional. Es así que la insuficiencia cardiaca como un complejo sintomático clínico, puede llevar al niño a un estado crítico, en el que por medio de mecanismos compensatorios el organismo del niño trata de mantener el gasto cardiaco y aporte de oxígeno tisular en límites normales, con relativa dependencia de la edad en éste. El alto índice de mortalidad en todos los grupos de edad pediátrica, en ausencia de medidas terapéuticas rápidas y eficaces; reflejan la importancia de que exista personal de salud y en particular de enfermería involucrado en los protocolos de atención específicos en este grupo de pacientes. Para garantizar la efectividad de las intervenciones de enfermería, se requiere un personal con dominio en el conocimiento de la fisiopatología, tratamiento farmacológico, efectos terapéuticos y adversos, y cuidados de enfermería; los cuales deben basarse en diagnósticos basados en las necesidades del paciente pediátrico y dirigidos hacia una gestión de calidad para un cuidado de enfermería científico, humano y espiritual. Razón por la cual, el presente trabajo tiene como propósito hacer evidente la importancia en la pertinencia y oportunidad de la intervención profesional de la enfermera con el equipo multidisciplinario de salud, en la toma de decisiones conjuntas para la atención idónea del paciente pediátrico con síndrome de insuficiencia cardiaca.

Congenital cardiopathies represent 90% of heart failure and the fifth place in the national score. Cardiac insufficiency, as a clinical symptomatic complex, can lead a child to a critical state, where the human body utilizes compensatory mechanisms to keep the cardiac intake and tissue oxygen support within normal limits according, relatively, with the child'sage. The high mortality rate, in all pediatric age groups when there is not efficient and quick therapeutic measurements, shows the importance of existing health personnel and particularly nursing staff involved in the specific caring protocols in this group of patients. In order to guarantee the effectiveness of nursing interventions, it is required personnel who domain knowledge about Physiopathology, pharmacologic treatment, therapeutic and side effects, and nursing care; which should be based on the needs of the pediatric patient and leading toward a quality appeal with a scientific, human, and spiritual nursing care. For that reason, this report has as an objective evidencing the importance of pertinence and opportune professional intervention from nurses with the multidisciplinary team health, and making shared decisions to give the ideal care to the pediatric patient with cardiac insufficiency syndrome.

Prevention and health promotion in clinical practice: the views of general practitioners in Europe.

BACKGROUND: Disease prevention and health promotion are important tasks in the daily practice of all general practitioners (GPs). The objective of this study was to explore the knowledge and attitudes of European GPs in implementing evidence-based health promotion and disease prevention recommendations in primary care, to describe GPs' perceived barriers to implementing these recommendations and to assess how GPs' own health behaviors affect their work with their patients. METHODS: A postal multinational survey was carried out from June to December 2000 in a random sample of GPs listed from national colleges of each country. RESULTS: Eleven European countries participated in the study, giving a total of 2082 GPs. Although GPs believe they should advise preventive and health promotion activities, in practice, they are less likely to do so. About 56.02% of the GPs answered that carrying-out prevention and health promotion activities are difficult. The two most important barriers reported were heavy workload/lack of time and no reimbursement. Associations between personal health behaviour and attitudes to health promotion or activities in prevention were found. GPs who smoked felt less effective in helping patients to reduce tobacco consumption than non-smoking GPs (39.34% versus 48.18%, P < 0.01). GPs who exercised felt that they were more effective in helping patients to practice regular physical exercise than sedentary GPs (59.14% versus 49.70%, P < 0.01). CONCLUSIONS: Significant gaps between GP's knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention in primary care.

Dietary advice in clinical practice: the views of general practitioners in Europe.

BACKGROUND: General practitioners (GPs) can promote good nutrition to patients and advise them about desirable dietary practices for specific conditions. OBJECTIVE: The objective was to assess GPs' knowledge and attitudes in implementing preventive and health promotion activities and to describe tools used by European GPs in advising patients about dietary practices. DESIGN: A postal survey was mailed to 1976 GPs from 10 GP national colleges to obtain information about beliefs and attitudes in prevention and health promotion, and an e-mail survey was sent to 15 GPs representing national colleges to obtain information about dietary guidelines. RESULTS: In the postal survey, 45% of GPs reported estimating body mass in clinical practice, and 60% reported advising overweight patients to lose weight. Fifty-eight percent answered that they felt minimally effective or ineffective in helping patients achieve or maintain normal weight. In the e-mail survey, only 4 colleges out of 15 reported that they had published their own dietary tools, although 10 out of 15 answered that GPs use some nutritional/dietary recommendations in the office when seeing patients. Eleven out of 15 answered that both the nurse and the GP advise patients about dietary practices, with 4 answering that GPs were the only ones who advise patients. Only 5 delegates answered that they can refer their patients to trained nutrition specialists. CONCLUSIONS: GPs think that obesity is not easy to handle in practice. Most GPs have dietary tools in the office and think that nurses play an important role in advising patients.