The Effectiveness of Negative Pressure Therapy: Nursing Approach.

INTRODUCTION: Complex wounds require advanced techniques for their management and care. Wound care costs are high, so healthcare professionals need to be aware of available therapies. Negative pressure therapy is a technology for which more and more data on its effectiveness in complex wounds are being collected. OBJECTIVE: The objectives of this review were to analyze if the application of negative pressure therapy in complex wounds is effective; to compare the effectiveness of negative pressure therapy with other conventional treatments, as well as its combination with other therapies; and to evaluate the quality of life of patients undergoing negative pressure therapy and collect their main characteristics. METHODOLOGY: A bibliographic review focused on articles published between November 2015 and June 2022 was carried out. The following databases were consulted: PubMed (Medline), Google Scholar, Web of Science (WOS), Scielo and Scopus. RESULTS: The most used pressures in the studies coincide at -125 mmHg and in the range of -125 mmHg to -150 mmHg. In the pediatric population, pressure levels vary by age group. A pressure of -75 to -125 mmHg is recommended for children over 12 years of age, and -50 to -75 mmHg is recommended for children under 2 years of age. CONCLUSIONS: Negative pressure therapy stands out for its rapid rate of granulation, the prevention and effective treatment of infections, the variety and malleability of dressings, its various applications and the possibility of using it with other therapies to accelerate wound closure.

Antibody response in patients admitted to the hospital with suspected SARS-CoV-2 infection: results from a multicenter study across Spain.

AIM: To evaluate the serological response against SARS-CoV-2 in a multicenter study representative of the Spanish COVID pandemic. METHODS: IgG and IgM + IgA responses were measured on 1466 samples from 1236 Spanish COVID-19 patients admitted to the hospital, two commercial ELISA kits (Vircell SL, Spain) based on the detection of antibodies against the viral spike protein and nucleoprotein, were used. RESULTS: Approximately half of the patients presented antibodies (56.8% were IgM + IgA positive and 43.0% were IgG positive) as soon as 2 days after the first positive PCR result. Serological test positivity increased with time from the PCR test, and 10 days after the first PCR result, 91.5% and 88.0% of the patients presented IgM + IgA and IgG antibodies, respectively. CONCLUSION: The high values of sensitivity attained in the present study from a relatively early period of time after hospitalization support the use of the evaluated serological assays as supplementary diagnostic tests for the clinical management of COVID-19.

Comparative Evaluation of Indirect Immunofluorescence and NS-1-Based ELISA to Determine Zika Virus-Specific IgM.

Differential diagnosis of the Zika virus (ZIKV) is hampered by cross-reactivity with other flaviviruses, mainly dengue viruses. The aim of this study was to compare two commercial methods for detecting ZIKV immunoglobulin M (IgM), an indirect immunofluorescence (IIF) and an enzyme immunoassay (ELISA), using the non-structural (NS) 1 protein as an antigen, both from EuroImmun, Germany. In total, 255 serum samples were analyzed, 203 of which showed laboratory markers of ZIKV infections (PCR-positive in serum and/or in urine and/or positive or indeterminate specific IgM). When tested with IIF, 163 samples were IgM-positive, while 13 samples were indeterminate and 78 were negative. When IIF-positive samples were tested using ELISA, we found 61 positive results, 14 indeterminate results, and 88 negative results. Among the indeterminate cases tested with IIF, ELISA analysis found two positive, two indeterminate, and nine negative results. Finally, 74 of the 78 IIF-negative samples proved also to be negative using ELISA. For the calculations, all indeterminate results were considered to be positive. The agreement, sensitivity, and specificity between ELISA and IIF were 60.2%, 44.9%, and 94.9%, respectively. Overall, 101 samples showed discrepant results; these samples were finally classified on the basis of other ZIKV diagnostic approaches (PCR-positive in serum and/or in urine, IgG determinations using IIF or ELISA, and ZIKV Plaque Reduction Neutralization test-positive), when available. A final classification of 228 samples was possible; 126 of them were positive and 102 were negative. The corresponding values of agreement, sensitivity, and specificity of IIF were 86.0%, 96.8%, and 72.5%, respectively. The corresponding figures for ELISA were 81.1%, 65.9%, and 100%, respectively. The ELISA and IIF methods are both adequate approaches for detecting ZIKV-specific IgM. However, considering their respective weaknesses (low sensitivity in ELISA and low specificity in IIF), serological results must be considered jointly with other laboratory results.

Sífilis y embarazo: estudio de 94 casos / Syphilis and pregnancy: Study of 94 cases

Fundamento y objetivo: Estudiar la epidemiología, manifestaciones clínicas, diagnóstico, tratamiento, seguimiento y resultados perinatales de la sífilis durante el embarazo. Pacientes y método: Estudio retrospectivo de 94 gestantes con sífilis cuya gestación y parto se controlaron en un Servicio de Obstetricia desde 2002 a 2010 entre un total de 85.806 partos de gestantes sin sífilis en el mismo período. Resultados: La prevalencia de sífilis en el embarazo fue de 0,11%. La mayoría de las gestantes eran de procedencia extranjera y el tipo de sífilis más prevalente fue la latente tardía. Realizaron el tratamiento correcto solo 57 pacientes, a pesar de la adecuada prescripción médica. En 31 gestantes se comprobaron complicaciones maternas durante el embarazo y en 16 casos hubo complicaciones fetales. En los neonatos se diagnosticaron 4 casos de sífilis congénita, 3 de ellos con meningitis sifilítica, cuyas madres no habían realizado el tratamiento de forma correcta. Conclusiones: La realización obligatoria de una serología de sífilis en el primer trimestre de embarazo permite diagnosticar muchos casos de sífilis latente tardía. Tras la detección precoz de las gestantes infectadas se debe asegurar la correcta realización del tratamiento para prevenir la transmisión vertical (AU)

Background and objective: To study the epidemiology, diagnosis, treatment strategies and perinatal outcomes of gestational syphilis. Patients and method: We performed a retrospective study of 94 pregnant women with syphilis whose gestation and delivery were monitored in a Department of Obstetrics from 2002 to 2010 among a total of 85,806 births of women without syphilis in the same period. Results: The prevalence of gestational syphilis was 0.11%. Most of the women were foreign and the most prevalent type was late latent syphilis. Only 57 patients underwent right treatment despite adequate prescription. Maternal complications were confirmed in 31 pregnant women and 16 cases had fetal complications. We diagnosed 4 cases of neonatal syphilis, 3 of them with syphilitic meningitis, whose mothers had not completed the treatment correctly. Conclusions: The implementation of a mandatory syphilis serology in the pregnancy has enabled us to diagnose many cases of late latent syphilis. The successful completion of treatment must be ensured to prevent vertical transmission (AU)

[Syphilis and pregnancy: study of 94 cases]. / Sífilis y embarazo: estudio de 94 casos.

BACKGROUND AND OBJECTIVE: To study the epidemiology, diagnosis, treatment strategies and perinatal outcomes of gestational syphilis. PATIENTS AND METHOD: We performed a retrospective study of 94 pregnant women with syphilis whose gestation and delivery were monitored in a Department of Obstetrics from 2002 to 2010 among a total of 85,806 births of women without syphilis in the same period. RESULTS: The prevalence of gestational syphilis was 0.11%. Most of the women were foreign and the most prevalent type was late latent syphilis. Only 57 patients underwent right treatment despite adequate prescription. Maternal complications were confirmed in 31 pregnant women and 16 cases had fetal complications. We diagnosed 4 cases of neonatal syphilis, 3 of them with syphilitic meningitis, whose mothers had not completed the treatment correctly. CONCLUSIONS: The implementation of a mandatory syphilis serology in the pregnancy has enabled us to diagnose many cases of late latent syphilis. The successful completion of treatment must be ensured to prevent vertical transmission.

Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active-surveillance report.

OBJECTIVE: The long-term safety of therapeutic agents that neutralize tumor necrosis factor (TNF) is uncertain. Recent evidence based on spontaneous reporting shows an association with active tuberculosis (TB). We undertook this study to determine and describe the long-term safety of 2 of these agents, infliximab and etanercept, in rheumatic diseases based on a national active-surveillance system following the commercialization of the drugs. METHODS: We analyzed the safety data actively collected in the BIOBADASER (Base de Datos de Productos Biológicos de la Sociedad Española de Reumatología) database, which was launched in February 2000 by the Spanish Society of Rheumatology. For the estimation of TB risk, the annual incidence rate in patients treated with these agents was compared with the background rate and with the rate in a cohort of patients with rheumatoid arthritis (RA) assembled before the era of anti-TNF treatment. RESULTS: Seventy-one participating centers sent data on 1,578 treatments with infliximab (86%) or etanercept (14%) in 1,540 patients. Drug survival rates (reported as the cumulative percentage of patients still receiving medication) for infliximab and etanercept pooled together were 85% and 81% at 1 year and 2 years, respectively. Instances of discontinuation were essentially due to adverse events. Seventeen cases of TB were found in patients treated with infliximab. The estimated incidence of TB associated with infliximab in RA patients was 1,893 per 100,000 in the year 2000 and 1,113 per 100,000 in the year 2001. These findings represent a significant increased risk compared with background rates. In the first 5 months of 2002, after official guidelines were established for TB prevention in patients treated with biologics, only 1 new TB case was registered (in January). CONCLUSION: Therapy with infliximab is associated with an increased risk of active TB. Proper measures are needed to prevent and manage this adverse event.

Implantación del proceso enfermero / The implantation of the nursing process

Introducción: Uno de los acontecimientos básicos que han influido en el avance de la profesión de Enfermería ha sido la introducción del Proceso Enfermero (PE) como método científico, pero sin embargo sigue siendo un tema muy controvertido. Se efectúa un estudio en todo el Estado Español que aporte información respecto al número de centros de Atención Primaria que están usando el PE y por cuántos enfermeros. Metodología: Estudio analítico. Centros de Atención Primaria en todo el territorio del Estado Español, escogidos a través de un muestreo sistemático, con un nivel de confianza del 95 por ciento (un total de 500 centros de salud).Resultados: El 43 por ciento de los centros aplican la metodología enfermera. El porcentaje de enfermeros que los aplican es del 33 por ciento. Discusión: Existe una importante parte de los centros y los enfermeros que trabajan en Atención Primaria que usa la metodología, pero las mismas cifras nos hablan de un porcentaje aún mayor de enfermeros que no lo usan. Otro dato a tener en cuenta es que aquellos centros donde se han desarrollado cursos de formación en esta metodología, lo usan casi el doble que los que no lo han recibido (AU)

[Implanting the nursing process]. / Implantación del proceso enfermero.

INTRODUCTION: One of the basic events which has made an impact on the advance of the Nursing profession has been the introduction of the Nursing Process as a scientific method; however, this topic is still very controversial. The authors have carried out a study throughout Spain which compiles data regarding the number of Primary Health Centers which use the Nursing Process as well as how many nurses use this method. METHODOLOGY: An analytic study using Primary Heath Centers throughout Spain chosen by means of a systematic sampling method having a 95% confidence level on a total of 500 health centers. RESULTS: 43% of these centers apply this nursing method. 33% of nurses apply this process. COMMENTS: An important number of health centers and nurses who work in primary health care use this nursing process, but this same data indicate that an even higher number of nurses do not use this method. Another statistic to bear in mind is that in those centers where professional development classes in this methodology have been set up, almost double the number of nurses use this process than in centers where there have been no such classes.