Gender differences and health inequality: Evolution of cardiovascular risk in workers.

The aim was to find out if there are any such differences due to gender in a cohort of workers followed for ten years, comparing their lifestyles and following the evolution of the main cardiovascular risk factors (CVRF) and their impact on cardiovascular risk. An observational longitudinal study of 698 civil servants workers (186 women and 512 men) of a local government office from Córdoba (Spain), was conducted over the period 2003-2014. We compared the initial and final prevalence of physical activity, smoking, obesity, hypertension, metabolic syndrome and diabetes. Cardiovascular risk was also assessed using the REGICOR (Registre Gironí del Cor) and SCORE (Systematic Coronary Risk Evaluation) equations. There was a greater rise in the prevalence of hypertension and hypercholesterolemia in the cohort in women than in men (94.2% vs. 38% and 92% vs 21.1%), while the reduction in smoking also differed by gender (26.4% vs. 36.5%). It could be that since women present a lower cardiovascular risk profile, they are treated less or less effort is made to keep the risk factors low, resulting in a worse evolution of smoking, hypercholesterolemia and hypertension in women.

Dolor en la artrosis de rodilla / Pain in knee osteoarthritis

El dolor constituye el síntoma fundamental de la artrosis, sus características e interpretación permiten el diagnóstico certero y también conocer la magnitud de esa entidad. El objetivo de este trabajo, es profundizar los conocimientos sobre los elementos más esenciales relacionados con el dolor en la artrosis de la rodilla. Se describen las causas mecánicas y bioquímicas del dolor, entre las que resaltan el dolor óseo, sinovial, así como los factores bioquímicos relacionados con ese síntoma. Se hace referencia a las principales estructuras anatómicas responsables del dolor y sus mecanismos de acción. Se mencionan la relación existente entre ese síntoma y las modalidades imagenológicas, así como los patrones del dolor. Para finalizar, se hace referencia a las escalas de dolor usadas.

Pain is the main symptom of osteoarthritis. Determining the distinctive features of pain in knee osteoarthritis allows for an accurate diagnosis. This article gives a review of the results from research work on the typical features of knee osteoarthritic pain. The mechanics and biochemical causes of pain are described including both bone and synovial biochemical symptom-related factors. The relationships between knee pain, various imaging techniques and pain mechanism are also identified. Finally, the used pain scales are presented.

[Relationship between angular deformity and primary osteoarthritis of the knee. Review article]. / Relación entre deformidad angular y gonartrosis primaria.

BACKGROUND: Osteoarthritis of the knee is a common disease and angular deformities are usually associated to this degenerative affection. Secondary causes of angular deformities are well known in the scientific literature, but there are not many articles about the relationship between angular deformities and primary osteoarthritis. OBJECTIVE: To deepen in the relationship between angular deformities and primary osteoarthritis of the knee. METHOD: We conducted a literature review of a total of 300 articles in PubMed, Medline and Hinari locator information by EndNote, 52 of them were used and selected quotes to do the review, 47 of them in the last five years, including five books. DEVELOPMENT: A revision of important biochemical and biomechanics aspects were made in regards to the relationship between angular deformities and primary osteoarthritis of the knee. Causes of deformities according to the sagittal, coronal and rotational axis were taken into account. Factors related to deformities could be osseous or soft tissues of the knee joint. CONCLUSIONS: Deformities of the knee in patients suffering from primary osteoarthritis are common and there are osseous and soft tissues causes to justified the presence of these deformities.

ANTECEDENTES: La gonartrosis es una entidad muy frecuente en la actualidad, las deformidades angulares son un hallazgo usual en pacientes con esta entidad y aunque está bien justificada su presencia como causa secundaria, no existen muchos reportes sobre la relación entre deformidad angular y gonartrosis primaria. OBJETIVO: Profundizar en la relación existente entre gonartrosis primaria y deformidad angular de la articulación de la rodilla. MÉTODO: Se realizó una revisión bibliográfica de un total de 300 artículos publicados en PubMed, Hinari y Medline mediante el localizador de información EndNote, de ellos se utilizaron 52 citas seleccionadas para realizar la revisión, 47 de ellas de los últimos cinco años, donde se incluyeron cinco libros. DESARROLLO: Se realizó una revisión de los aspectos bioquímicos y biomecánicos más importantes relacionados con las deformidades angulares. Con respecto a la asociación entre deformidad angular y gonartrosis primaria, se plasmaron los elementos relacionados con cada tipo de deformidad tanto en el eje axial, coronal como rotacional. Los factores relacionados con la deformidad pueden ser de tipo óseo y de partes blandas, en especial del aparato capsuloligamentoso de la articulación. CONCLUSIONES: Las deformidades angulares en pacientes con gonartrosis primaria son frecuentes y en su presencia influyen factores relacionados con la arquitectura ósea y de partes blandas.

Medidas no farmacológicas para el tratamiento del síndrome confusional agudo en la unidad de cuidados intensivos / Non-pharmacological steps for the treatment of acute confusional syndrome in the intensive care unit

El delirium tiene una elevada incidencia en las unidades de cuidados intensivos y se encuentra infradiagnosticado e infratratado. Objetivo: Describir las experiencias de las enfermeras de la UCI de adultos en la identificación y aplicación de las medidas no farmacológicas para la prevención y tratamiento del delirium. Método: Estudio cualitativo fenomenológico, mediante grupos de discusión. Criterio de inclusión: enfermeras de UCI con un año o más de experiencia. Muestreo: por propósito y técnica de bola de nieve. Recogida de datos: grupos de discusión que se transcribieron para su análisis. Se realizó análisis temático de los textos. Resultados: Cuatro temas identificados: a) la estructura física y social de la UCI; b) la implicación de la familia; c) la necesidad de formación de los profesionales sanitarios; y d) favorecer el ciclo sueño-vigilia. Conclusiones: Controlar el medio ambiente de la UCI para hacerlo más amigable, modificar la rutina de trabajo para favorecer el descanso, implementar acciones de formación y flexibilizar el horario de visitas

The incidence of delirium in intensive care units is high and it has been under diagnosed and under-treated. Objective: To describe the experiences of ICU nurses in the identification and application of non-pharmacological treatments. Method: A qualitative phenomenological research study was performed, based on focus groups. Inclusion criteria: ICU nurses with one year of more of experience were included. Sample Purpose and snowball technique. Data collection: Data from the focus groups were transcribed for analysis and a thematic analysis of the texts was performed. Results: Four themes were identified: a) the physical and social structure of the ICU b) family involvement, c) need for training of health professionals, and d) encouraging the sleep-wake cycle. Conclusions: It is necessary to control the ICU environment to make it more friendly, to change the routine work to promote relaxation, implement training activities and to make visiting hours flexible

[Non-pharmacological steps for the treatment of acute confusional syndrome in the intensive care unit]. / Medidas no farmacológicas para el tratamiento del síndrome confusional agudo en la unidad de cuidados intensivos.

UNLABELLED: The incidence of delirium in intensive care units is high and it has been under-diagnosed and under-treated. OBJECTIVE: To describe the experiences of ICU nurses in the identification and application of non-pharmacological treatments. METHOD: A qualitative phenomenological research study was performed, based on focus groups. INCLUSION CRITERIA: ICU nurses with one year of more of experience were included. Sample Purpose and snowball technique. DATA COLLECTION: Data from the focus groups were transcribed for analysis and a thematic analysis of the texts was performed. RESULTS: Four themes were identified: a) the physical and social structure of the ICU b) family involvement, c) need for training of health professionals, and d) encouraging the sleep-wake cycle. CONCLUSIONS: It is necessary to control the ICU environment to make it more friendly, to change the routine work to promote relaxation, implement training activities and to make visiting hours flexible.

El significado del lenguaje estandarizado NANDA-NIC-NOC en las enfermeras de cuidados intensivos madrileñas: abordaje fenomenológico / The meaning of standardized language nanda-nic-noc intensive care nurses in madrid: a phenomenological approach

ResumenEl lenguaje estandarizado de la enfermería es un instrumento que permite integrar un marco teórico de identificación de problemas, intervenciones y resultados en los cuidados. Su utilización en diversos medios asistenciales es variada. En el caso de las unidades de cuidados intensivos es preciso estudiar las implicaciones que tiene la integración de este lenguaje en las enfermeras.ObjetivoDescribir el significado del lenguaje estandarizado NANDA-NIC-NOC para las enfermeras que trabajan en las Unidades de Cuidados Intensivos madrileñas (UCIM).MétodoEstudio cualitativo fenomenológico. Criterio de inclusión: enfermeras de UCIM con un año o más de experiencia que en el momento del estudio estuvieran trabajando en UCIM.MuestreoPor propósito y técnica de bola de nieve.Recogida de datosEntrevistas no-estructuradas, documentos personales (cartas, diarios). Se grabaron las entrevistas y se transcribieron palabra por palabra para su posterior análisis.AnálisisPropuesta de Giorgi. Identificación de unidades de significado, grupos de significado comunes y temas.Resultados3 temas construyen el significado de las enfermeras de cuidados intensivos; Vivir integrando 2 caras de la misma moneda, vivir una imposición conceptual, y vivir una oportunidad de desarrollo y autonomía profesional.ConclusionesExiste una distancia en la teoría del lenguaje y su aplicación en la clínica. Las enfermeras refieren sentir una imposición conceptual de un determinado lenguaje. Esto crea la construcción de una jerarquía entre enfermeras basada en el uso de NANDA-NIC-NOC. Aun así, el lenguaje estandarizado es vivido como una oportunidad de desarrollo profesional (AU)

AbstractNursing standardized language is a tool that makes it possible to integrate a theoretical framework of problem identification, interventions and outcomes in care. Its use in the difference care settings is varied. In the case of intensive care units, it is necessary to study the implications that integration of this language would have in nursing area.ObjectiveTo describe the meaning of standardized NANDA-NIC-NOC language for the nurses working in Intensive Care Units in Madrid.MethodA phenomenological qualitative study was conducted. Inclusion criteria: ICU in Madrid of nurses with one year or more experience at the time of the study who were working in the ICU.SamplePurposive and Snowball sampling technique.Data collectionUnstructured interviews, personal documents (letters, diaries). Interviews were recorded and transcribed verbatim for later analysis.AnalysisGiorgi proposal. Identifying meaning units, groups of common senses and themes.ResultsThree themes made up the meaning of standardized language in intensive care nursing. "Living integrating 2 sides of the same coin", "living a conceptual imposition", and "living a development opportunity and professional autonomy".ConclusionsThere is a gap in the theory of language and its clinical application. Nurses report feeling imposition of a specific conceptual language. This creates the construction of a hierarchy between nurses based on the use of NANDA-NIC-NOC. Even so, the standardized language is experienced as a professional development opportunity (AU)

[The meaning of standardized language NANDA-NIC-NOC intensive care nurses in Madrid: a phenomenological approach]. / El significado del lenguaje estandarizado NANDA-NIC-NOC en las enfermeras de cuidados intensivos madrileñas: abordaje fenomenológico.

UNLABELLED: Nursing standardized language is a tool that makes it possible to integrate a theoretical framework of problem identification, interventions and outcomes in care. Its use in the difference care settings is varied. In the case of intensive care units, it is necessary to study the implications that integration of this language would have in nursing area. OBJECTIVE: To describe the meaning of standardized NANDA-NIC-NOC language for the nurses working in Intensive Care Units in Madrid. METHOD: A phenomenological qualitative study was conducted. INCLUSION CRITERIA: ICU in Madrid of nurses with one year or more experience at the time of the study who were working in the ICU. SAMPLE: Purposive and Snowball sampling technique. DATA COLLECTION: Unstructured interviews, personal documents (letters, diaries). Interviews were recorded and transcribed verbatim for later analysis. ANALYSIS: Giorgi proposal. Identifying meaning units, groups of common senses and themes. RESULTS: Three themes made up the meaning of standardized language in intensive care nursing. "Living integrating 2 sides of the same coin", "living a conceptual imposition", and "living a development opportunity and professional autonomy". CONCLUSIONS: There is a gap in the theory of language and its clinical application. Nurses report feeling imposition of a specific conceptual language. This creates the construction of a hierarchy between nurses based on the use of NANDA-NIC-NOC. Even so, the standardized language is experienced as a professional development opportunity.

The mPer1 clock gene expression in the rd mouse suprachiasmatic nucleus is affected by the retinal degeneration.

Endogenous rhythms of mammals are controlled by the clock located in the suprachiasmatic nucleus (SCN). The molecular mechanism of a clock involves transcription/translation-based feedback loops in which the expression of the so called "clock genes" is suppressed periodically by their protein products. Previous studies reported influence of the eye itself on the circadian oscillation of the SCN, apart from the well-known photic readjustment of the central clock. With this in mind, we decided to analyze the mPer1 clock gene expression in the retinally degenerate (rd) mouse SCN by means of immunohistochemical techniques. Our objective was to detect possible alterations of the daily endogenous oscillation of PER1 protein in the SCN of these rd mice, as well as to make clear whether or not this protein was involved in the resetting of the central clock in a manner similar to wild-type animals. We found that the endogenous levels of PER1 protein were reduced in the SCN of rd mice throughout the 24-h cycle, which suggests that loss of classic photoreceptors influences somehow the main mechanism of the SCN clock. Light stimulation induced a parallel increase of Per1 expression at the subjective night, but not at the subjective day, in both rd and wild-type mice. Therefore, SCN readjustment by light in the rd mice occurs with a pattern similar to wild-type controls, despite the reduced PER1 protein levels detected. The effect of retinal degeneration on the circadian system and the possible interactions between the retinal and the SCN clocks are discussed.

Identification of extraretinal photoreceptors in the teleost Phoxinus phoxinus.

The existence of cells capable of detecting changes of the photoperiod within the deep brain, the so-called deep brain photoreceptors, was proposed in the early years of the twentieth century. By using immunocytochemistry with antisera against phototransductory proteins on paraffin and vibratome sections, we have localized several positive areas in the brain of the teleost Phoxinus phoxinus. These areas were restricted to two encephalic regions: the epithalamus and the hypothalamus. Immunopositive (rod-opsin- and a-transducin-like) pinealocytes and parapinealocytes, as well as some sparse neurons in the habenula, were seen in the epithalamus. The immunoreaction of the hypothalamus was represented by a-transducin-like positive (magnocellular and parvicellular) neurons of the Nucleus Preopticus, as well as by a-transducin- and arrestin-like positive fibers corresponding to the hypothalamic-hypophyseal tract and a few fibers running towards the basal telencephalon. These findings corroborate the data published on other teleost fish and fully support the hypothesis of the presence of photosensitive cells in the encephalon of lower vertebrates. The labelling with antisera against different components of the phototransductory cascade also strengthens the idea that such cells employ a biochemical mechanism similar to that in the retinal visual photoreceptor cells, rods and cones. Although the function is still unclear, the detection of the photoperiod seems to be the most likely role for these extraretinal photoreceptors.