Consenso ibérico de buenas prácticas clínicas en tratamientos estéticos con toxina botulínica tipo A / Iberian consensus of good clinical practices in aesthetic treatments with Abobotulinum toxin A

Introducción y objetivo: Con la evolución de la experiencia en el uso de la toxina botulínica tipo A para tratamientos estéticos se necesitan guías actualizadas de buenas prácticas clínicas. El objetivo de este trabajo fue desarrollar recomendaciones actualizadas para buenas prácticas en el uso clínico diario, con el fin de optimizar el manejo del paciente estético y los resultados obtenidos con la toxina botulínica tipo A. Material y método: Un panel de 44 participantes con amplia experiencia en el uso de la toxina Abobotulinum se reunió para revisar y discutir la evidencia disponible y la práctica clínica en la aplicación estética de la toxina Abobotulinum A. Resultados: Los temas discutidos para la creación de este consenso incluyeron cuestiones directamente relacionadas con el uso y las propiedades de la toxina botulínica tipo A (Azzalure®) y temas generales relativos a la práctica clínica: precisión y campo de efecto de la toxina botulínica tipo A, duración del efecto, rapidez en el inicio de acción, protocolos de tratamiento, tratamientos combinados de toxina botulínica tipo A y ácido hialurónico para mayor satisfacción del paciente y armonía facial, recomendaciones post-tratamiento, diagnóstico y valoración previa del paciente para un efecto óptimo, edad en la que los pacientes comienzan a ser tratados con la toxina y su recomendación como tratamiento preventivo según las escalas de envejecimiento Glogau I o II, manejo de las expectativas del paciente y valoración de la satisfacción del mismo. Conclusiones: Este consenso ha recogido las opiniones, consejos y experiencia de médicos estéticos con amplia experiencia en el uso de la toxina botulínica tipo A para ayudar a los profesionales a conseguir los mejores resultados posibles en términos de eficacia y satisfacción del paciente. (AU)

Background and objective: With the evolution of the experience in the use of botulinum toxin type A for aesthetic treatments, updated guidelines of good clinical practices are needed. The objective of this work was to develop updated recommendations for good practices in daily clinical use, in order to optimize the mana- gement of the aesthetic patient and the results obtained with botulinum toxin type A. Methods: A panel of 44 participants with extensive experience in the use of Abobotulinum toxin met to review and discuss the available evidence and clinical practice in the aesthetic application of Abobotulinum toxin A. Results: The topics discussed for the creation of this consensus included questions directly related to the use and properties of botulinum toxin type A (Azzalure®) and general topics related to clinical practice: precision and field of effect of botulinum toxin type A, duration of effect, speed of onset of action, treatment protocols, combined treatments of botulinum toxin type A and hyaluronic acid for greater patient satisfaction and facial harmony, post-treatment recommendations, diagnosis and prior assessment of the patient for optimal effect, age at which patients begin to be treated with the toxin and its recommendation as a preventive treatment according to the Glogau I or II aging scales, management of patient expectations and assessment of patient satisfaction. Conclusions: This consensus has collected the opinions, advice and experience of aesthetic doctors with extensive experience in the use of botulinum toxin type A to help professionals achieve the best possible results in terms of efficacy and patient satisfaction. (AU)

Reunión de consenso para recomendaciones sobre la gama de productos Restylane Skinboosters(R) / Advisory board recommendations on the products Restylane(R) Skinboosters

Con motivo del 10º aniversario de Restylane Skinboosters(R) se llevó a cabo una reunión de consenso entre un grupo de médicos españoles con el objetivo de aumentar el estándar de seguridad, mejorar y dar coherencia a los tratamientos, favorecer la buena praxis, posibilitar mejores resultados y aumentar la seguridad con esta gama de productos. Se realizó una revisión exhaustiva de los estudios clínicos publicados que demuestran cómo Restylane Skinboosters(R) mejora la calidad de la piel, disminuyendo la rugosidad, aumentando la firmeza e hidratación a largo plazo y reduciendo las cicatrices de acné, así como estimulando la creación de colágeno tipo I. Por último, los participantes pusieron en común su experiencia clínica para realizar un resumen de las indicaciones y los protocolos más empleados con esta gama de tratamientos (AU)

Related to the 10th anniversary of Restylane Skinboosters(TM) an advisory board was carried out. It gathered a group of Spanish physicians with the aim of increasing the safety standards, improve treatments, encourage good practice, increase safety and enable better results using this product range. An exhaustive review of published clinical studies demonstrates that Restylane Skinboosters(TM) improve firmness and quality of the skin, reduce roughness, provide long-term hydration and reduce acne scars. It also stimulates creation of collagen type I. Finally, doctors summarized main indications and the most appropriate protocols with these products based on their clinical experience (AU)

[Hospitalized children's parents' anxiety in critical care units]. / Ansiedad en padres de niños hospitalizados en unidades críticas.

UNLABELLED: Child hospitalization is a potentially stressful process that affects both patients and family members. OBJECTIVE: Describe the anxiety that the parents of admitted children at a Intensive Care Units, Pediatric (PICU) and/or Neonatal (NICU) during the first week of hospitalization. MATERIAL AND METHOD: Observational study descriptive, transversal conducted at the Gregorio Marañón Hospital, in PICU and NICU. The inclusion criteria were: patients who didn't exceed the week admitted but they were at hospital more than one day, patients whose therapeutic effort wasn't limited and spanish-speaker parents. The sample size was 60 parents. We designed a questionnaire to measure sociodemographic variables and others related with the social support. The resulting variable, anxiety like State Anxiety (SA) and Trait Anxiety (TA) were determined by the STAI inventory. RESULTS: All the parents showed anxiety the average females SA was 44.59 (+/- 8.02) while the average of men was 44.32 (+/- 6.69). The results show a TA average of 34.73 (+/- 4.09) in woman and 34.95 (+/- 4.93) in men. 83% of the parents of the sample participated in their child caring, having this variable relationship with level of SA (p<0.05). Moreover 98% of parents understood the information given and were satisfied with it. CONCLUSION: All the parents presented anxiety, both SA and TA. They felt informed and supported by nurse. All these actions are directed towards an integral attention taking into account the family as the unit.

Ansiedad en padres de niños hospitalizados en unidades críticas / Hospitalized children's parents' anxiety in critical care units

La hospitalización infantil es un proceso potencialmente estresante que afecta al paciente y su familia. Objetivo: describir la ansiedad de padres de pacientes ingresados en Unidades de Cuidados Intensivos Pediátricas (UCIP) y/o Neonatales (UCIN), durante la primera semana de hospitalización. Material y método: estudio observacional descriptivo transversal desarrollado en el Hospital Universitario Gregorio Marañón, en UCIP y UCIN. Los criterios de inclusión fueron: padres de pacientes que no excedieran de una semana ingresados pero que lo estuvieran más de un día, de pacientes sin esfuerzo terapéutico limitado y padres hispano hablantes. La muestra consta de 60 padres. A través de un cuestionario de elaboración propia se midieron variables sociodemográficas y relacionadas con el apoyo social. La variable resultado ansiedad, como ansiedad estado (AE) y rasgo (AR) se determinó con el cuestionario STAI. Resultados: toda la muestra presentó ansiedad, la media en mujeres indicó AE 44,59 ('b18,02), y en hombres de 44,32('b16,69). La AR en mujeres supuso 34,73 ('b14,09) y en hombres de 34,95('b14,93). El 83% de los padres participó en el cuidado de su hijo, teniendo esta relación variable con la AE (p<0,05). Además un 98% entendió la información y se sintió satisfecha con ella. Conclusión: todos los padres presentan ansiedad, tanto AE como AR. Destacamos que se sintieron informados y apoyados por el personal de enfermería. Todas estas acciones nos encaminan hacia una atención integral, teniendo en cuenta a la familia como unidad asistencial(AU)

Child hospitalization is a potentially stressful process that affects both patients and family members. Objective: Describe the anxiety that the parents of admitted children at a Intensive Care Units, Pediatric (PICU) and/or Neonatal (NICU) during the first week of hospitalization. Material and method: Observational study, descriptive, transversal conducted at the Gregorio Marañón Hospital, in PICU and NICU. The inclusion criteria were: patients who didn’t exceed the week admitted but they were at hospital more than one day, patients whose therapeutic effort wasn’t limited and spanish-speaker parents. The sample size was 60 parents. We designed a questionnaire to measure sociodemographic variables and others related with the social support. The resulting variable, anxiety, like State Anxiety (SA) and Trait Anxiety (TA) were determined by the STAI inventory. Results: All the parents showed anxiety, the average females SA was 44.59 ('b18.02) while the average of men was 44.32('b16.69). The results show a TA average of 34.73 ('b14.09) in woman and 34.95('b14.93) in men. 83% of the parents of the sample participated in their child caring, having this variable relationship with level of SA (p<0.05). Moreover, 98% of parents understood the information given and were satisfied with it. Conclusion: All the parents presented anxiety, both SA and TA. They felt informed and supported by nurse. All these actions are directed towards an integral attention taking into account the family as the unit(AU)

Tratamiento de la artrosis. Intervención enfermera / Arthrosis treatment. Nursing intervention

Este artículo presenta el caso de una paciente con artrosis que reside en un centro de mayores, y que está siendo tratada, principalmente, con fármacos. Debido a su incapacidad se propone una intervención enfermera integral en la que se ha realizado una valoración de la agencia, el déficit, la demanda y los requisitos de autocuidado, y se desarrolla un plan de cuidados integrado básicamente por acciones educativas. El referente teórico que enmarca todo el proceso de cuidado es la Teoría de Autocuidado de Orem. Mediante esta intervención se pretende mejorar la calidad de vida de este tipo de pacientes y destacar la importancia que las acciones de apoyo educativo tienen en el cuidado(AU)

This article presents the case of a patient suffering from arthrosis residing in an elderly home and who is being treated mainly with pharmaceuticals. Due to that patient’s incapacity, an integral nursing intervention plan was proposed; for this plan, an evaluation was carried out by the agency, the deficit, the self-care needs and requirements, and a treatment plan integrated basically of educational action plans was developed. The theoretical reference which provides the framework for this entire process is Orem’s Theory of Self-Care. By means of this intervention, medical professionals hope to improve the life quality for this kind of patient and to highlight the importance that educational action plans have in the treatment of patients(AU)

[Arthrosis treatment. Nursing intervention]. / Tratamiento de la artosis. Intervención enfermera.

This article presents the case of a patient suffering from arthrosis residing in an elderly home and who is being treated mainly with pharmaceuticals. Due to that patient's incapacity an integral nursing intervention plan was proposed; for this plan, an evaluation was carried out by the agency, the deficit, the self-care needs and requirements, and a treatment plan integrated basically of educational action plans was developed. The theoretical reference which provides the framework for this entire process is Orem's Theory of Self-Care. By means of this intervention, medical professionals hope to improve the life quality for this kind of patient and to highlight the importance that educational action plans have in the treatment of patients.