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1.
Healthcare (Basel) ; 12(7)2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38610172

RESUMO

(1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of its functions and the creation of the professional profile in an equal manner. (2) Methods: A scoping review was conducted in order to achieve the main aim. Selected articles were subjected to a critical reading, and the levels of evidence and grades of recommendation of the Joanna Briggs Institute were verified. The search field was limited to the last ten years. (3) Results: Case management models are heterogeneous in different autonomous communities in Spain. Case nurse management is qualified for high-complexity patients, follow up on chronic patients, and coordinate health assistance. (4) Conclusions: It concludes that nursing's role is crucial in the field of case management, being required in the follow-up of chronic patients of high complexity. Despite the proven health benefits, efficacy, and efficiency of case management, there are many heterogeneous models that coexist in Spain. This involves a restriction in the development of a nursing career because of the lack of a definition of its functions and competences.

2.
Expert Opin Drug Saf ; 22(1): 71-79, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35574687

RESUMO

BACKGROUND: The use of hydroxychloroquine (HCQ) in the first COVID-19 epidemic wave raised safety concerns. RESEARCH DESIGN AND METHODS: Adverse reactions (ADR) suspected to be induced by HCQ and submitted to the Spanish Pharmacovigilance Database were studied. A disproportionality analysis was performed to determine adverse effects reported in non-Covid and Covid patients. To explore potential drug-drug interactions, Omega (Ω) statistics was calculated. RESULTS: More severe cases were reported when used in COVID-19. Main differences in frequency were observed in hepatobiliary, skin, gastrointestinal, eye, nervous system and heart ADRs. During the COVID-19 pandemic, high disproportionality in reports was found for Torsade de Pointes/QT prolongation with a ROR (-ROR) of 132.8 (76.7); severe hepatotoxicity, 18.7 (14.7); dyslipidaemias, 12.1 (6.1); shock, 9.5 (6.9) and ischemic colitis, 8.9 (2.6). Myopathies, hemolytic disorders and suicidal behavior increased their disproportionality during the pandemic. Disproportionality was observed for neoplasms, hematopoietic cytopaenias and interstitial lung disease in the pre-COVID-19 period. Potential interactions were showed between HCQ and azithromycin, ceftriaxone, lopinavir and tocilizumab. CONCLUSIONS: The use of HCQ during the Covid-19 pandemic changed its ADRs reporting profile. Of particular concern during the pandemic were arrhythmias, hepatotoxicity, severe skin reactions and suicide, but not ocular disorders. Some signals identified would require more detailed analyses.


Assuntos
COVID-19 , Doença Hepática Induzida por Substâncias e Drogas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Hidroxicloroquina/efeitos adversos , Pandemias , Tratamento Farmacológico da COVID-19
3.
Nurs Rep ; 12(3): 661-673, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36135985

RESUMO

The exploration of patterns of health beliefs about COVID-19 among nursing students may be beneficial to identify behaviors, attitudes and knowledge about contagion risk. We sought to analyze the variables of risk perception, perceived risk factors, coping style, sense of coherence and knowledge of preventive measures as possible predictors of having suffered from COVID-19. Participants were nursing students from 13 universities in Spain. Sociodemographic and health variables were collected. To test the independent variables, the Perception Risk Coping Knowledge (PRCK-COVID-19) scale was created and validated because there was no specific survey for young people adapted to the pandemic situation of COVID-19. It was validated with adequate psychometric properties. A total of 1562 students (87.5% female, mean age 21.5 ± 5.7 years) responded. The high perception of the risk of contagion, the high level of knowledge and a coping style focused on the situation were notable. Significant differences by gender were found in the coping styles, problem-focused, avoidance and knowledge scales, with women scoring higher in all categories. The multiple regression analysis was significant (F = 3.68; p < 0.001). The predictor variables were the coping styles subscale search for support and the intrinsic and extrinsic perceived risk factors. Our model predicts that nursing students with a social support-based coping style are at a higher risk of becoming infected with COVID-19, based on their own health belief model.

4.
J Clin Med ; 11(9)2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-35566585

RESUMO

In recent years, antioxidant supplements have become popular to counteract the effects of oxidative stress in fibromyalgia and one of its most distressing symptoms, pain. The aim of this systematic review was to summarize the effects of antioxidant supplementation on pain levels perceived by patients diagnosed with fibromyalgia. The words used respected the medical search terms related to our objective including antioxidants, fibromyalgia, pain, and supplementation. Seventeen relevant articles were identified within Medline (PubMed), Scopus, Web of Science (WOS), the Cochrane Database of Systematic Review, and the Cochrane Central Register of Controlled Trials. This review found that antioxidant supplementation is efficient in reducing pain in nine of the studies reviewed. Studies with a duration of supplementation of at least 6 weeks showed a benefit on pain perception in 80% of the patients included in these studies. The benefits shown by vitamins and coenzyme Q10 are remarkable. Further research is needed to identify the effects of other types of antioxidants, such as extra virgin olive oil and turmeric. More homogeneous interventions in terms of antioxidant doses administered and duration would allow the effects on pain to be addressed more comprehensively.

5.
J Pers Med ; 12(4)2022 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-35455631

RESUMO

As shown in the previous literature, in view of the future responsibilities of nursing professionals and the consequences for healthcare, it is of great interest to examine their risk perceptions, coping behaviors, and sense of coherency during the COVID-19 pandemic. The purpose of this study is to design and to validate a specific questionnaire that evaluates the factors relating to perceived risk, coping behaviors, and preventive knowledge against COVID-19 infection among nursing students from Spain. This is a psychometric study of a questionnaire's design and its validation in 1562 nursing students at 16 undergraduate nursing institutions in Spain. An ad-hoc survey was designed by a panel of six experts drawing from the literature. After a trial test, the questionnaire was formed with four scales (perception, risk, coping, and knowledge of preventive practices for COVID-19), with a total of 69 items. The final questionnaire was composed of 52 items grouped into four scales, with good psychometric properties to measure risk perception (Cronbach's alpha 0.735), factors related to perceived risk (Cronbach's alpha 0.653), coping behaviors (Cronbach's alpha 0.80), and knowledge of preventive practices against COVID-19 (Cronbach's alpha 0.77). This questionnaire, specifically designed and validated for nursing students, is the first to address four important areas in the development of preventive measures against COVID-19.

6.
Ann Med ; 54(1): 379-392, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35114859

RESUMO

BACKGROUND: Interindividual genetic variations contribute to differences in patients' response to drugs as well as to the development of certain disorders. Patients who use non-steroidal anti-inflammatory drugs (NSAIDs) may develop serious gastrointestinal disorders, mainly upper gastrointestinal haemorrhage (UGIH). Studies about the interaction between NSAIDs and genetic variations on the risk of UGIH are scarce. Therefore, we investigated the effect of 16 single nucleotide polymorphisms (SNPs) involved in drug metabolism on the risk of NSAIDs-induced UGIH. MATERIALS AND METHODS: We conducted a multicenter case-control study of 326 cases and 748 controls. Participants were sub-grouped into four categories according to NSAID exposure and genetic profile. We estimated odds ratios (ORs) and their 95% confidence intervals (CI) using generalized linear mixed models for dependent binomial variables and then calculated the measures of interaction, synergism index (S), and relative excess risk due to interaction (RERI). We undertook stratified analyses by the type of NSAID (aspirin, non-aspirin). RESULTS: We observed an excess risk of UGIH due to an interaction between any NSAID, non-aspirin NSAIDs or aspirin and carrying certain SNPs. The greatest excess risk was observed for carriers of: rs2180314:C>G [any NSAID: S = 3.30 (95%CI: 1.24-8.80), RERI = 4.39 (95%CI: 0.70-8.07); non-aspirin NSAIDs: S = 3.42 (95%CI: 1.12-10.47), RERI = 3.97 (95%CI: 0.44-7.50)], and rs4809957:A>G [any NSAID: S = 2.11 (95%CI: 0.90-4.97), RERI = 3.46 (95%CI: -0.40-7.31)]. Aspirin use by carriers of rs6664:C>T is also associated with increased risk of UGIH [ORaspirin(+),wild-type: 2.22 (95%CI: 0.69-7.17) vs. ORaspirin(+),genetic-variation: 7.72 (95%CI: 2.75-21.68)], yet larger sample size is needed to confirm this observation. CONCLUSIONS: The joint effect of the SNPs s2180314:C>G and rs4809957:A>G and NSAIDs are more than three times higher than the sum of their individual effects. Personalized prescriptions based on genotyping would permit a better weighing of risks and benefits from NSAID consumption.KEY MESSAGESMulticenter case-control study of the effect of genetic variations involved in drug metabolism on upper gastrointestinal haemorrhage (UGIH) induced by NSAIDs (aspirin and non-aspirin).There is a statistically significant additive synergism interaction between certain genetic polymorphisms and NSAIDs on UGIH: rs2180314:C>G and rs4809957:A>G. The joint effect of each of these single nucleotide polymorphisms and NSAIDs on UGIH is more than three times higher than the sum of their individual effects.Genetic profiling and personalized prescriptions would be useful in managing the risks and benefits associated with NSAIDs.


Assuntos
Anti-Inflamatórios não Esteroides , Aspirina , Anti-Inflamatórios não Esteroides/efeitos adversos , Aspirina/efeitos adversos , Estudos de Casos e Controles , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/genética , Humanos , Polimorfismo de Nucleotídeo Único , Fatores de Risco
7.
Nutrients ; 14(2)2022 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-35057442

RESUMO

Candidate gene studies have analyzed the effect of specific vitamin D pathway genes on vitamin D availability; however, it is not clear whether genetic variants also affect overall bone metabolism. This study evaluated the association between genetic polymorphisms in GC, CYP2R1 and CYP24A1 and serum levels of total 25(OH)D, iPTH and other mineral metabolism biomarkers (albumin, total calcium and phosphorus) in a sample of 273 older Spanish adults. We observed a significant difference between CYP2R1 rs10741657 codominant model and total 25(OH)D levels after adjusting them by gender (p = 0.024). In addition, the two SNPs in the GC gene (rs4588 and rs2282679) were identified significantly associated with iPTH and creatinine serum levels. In the case of phosphorus, we observed an association with GC SNPs in dominant model. We found a relationship between haplotype 2 and 25(OH)D levels, haplotype 4 and iPTH serum levels and haplotype 7 and phosphorus levels. In conclusion, genetic variants in CYP2R1 and GC could be predictive of 25(OH)D and iPTH serum levels, respectively, in older Caucasian adults. The current study confirmed the role of iPTH as one of the most sensitive biomarkers of vitamin D activity in vivo.


Assuntos
Densidade Óssea/genética , Colestanotriol 26-Mono-Oxigenase/genética , Família 2 do Citocromo P450/genética , Haplótipos , Hormônio Paratireóideo/sangue , Proteína de Ligação a Vitamina D/genética , Vitamina D3 24-Hidroxilase/genética , Vitamina D/análogos & derivados , Idoso , Idoso de 80 Anos ou mais , Cálcio/sangue , Creatinina/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Fósforo/sangue , Polimorfismo de Nucleotídeo Único , Albumina Sérica/análise , Fatores Sexuais , Vitamina D/sangue , População Branca
8.
Enferm. clín. (Ed. impr.) ; 31(6): 363-370, Nov-Dic. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-220662

RESUMO

Objetivo: Conocer el grado de participación de las enfermeras en la notificación espontánea de sospechas de reacciones adversas a medicamentos (RAM) al Sistema Español de Farmacovigilancia de Medicamentos de Uso Humano (SEFV-H), describir las características principales de los casos notificados e identificar puntos de mejora. Método: Estudio observacional descriptivo retrospectivo a partir de la información contenida en la base de datos FEDRA del SEFV-H. Se tomaron como muestra las notificaciones espontáneas de las RAM realizadas por enfermeras durante los seis primeros meses del 2018. Resultados: De las 6.370 sospechas de RAM notificadas por profesionales sanitarios en el periodo considerado, tan solo un 4,8% fueron realizadas por enfermeras. El 62,7% procede de centros extrahospitalarios y la mayoría de las RAM son consideradas no graves (78%). Las reacciones notificadas con más frecuencia son las reacciones locales. Los pacientes más implicados son los niños y las vacunas los medicamentos más notificados (58,3%), seguidas de los contrastes intravenosos para la realización de pruebas diagnósticas. Conclusiones: Las enfermeras notifican muy pocos casos al SEFV-H y están en su mayoría relacionados con la administración de vacunas y son enviados por enfermeras que trabajan en el medio extrahospitalario. La mayoría de los casos no presentan gravedad y suelen referir reacciones adversas conocidas para el fármaco sospechoso. Esta infranotificación observada plantea la necesidad de promover la formación en materia de farmacovigilancia entre estas enfermeras notificadoras para que continúen notificando, y también a las que no lo hacen en su práctica diaria, para que puedan comenzar a hacerlo.(AU)


Objective: This study aimed to gain knowledge of the nurses’ involvement in the spontaneous report of suspected adverse drug reactions (ADR) in the Spanish Pharmacovigilance System for Medicinal Products for Human Use (SEFV-H), describing the principal characteristics of the reported cases, identifying points of improvement. Methods: A descriptive observational retrospective study was based on the data from FEDRA, the database created by the SEFV-H. The sample taken was the spontaneous adverse drug reactions reported to SEFV-H by nurses during the first 6 months of the 2018. Results: Complete data was provided by 6,370 suspicions of ADR reported to SEFV-H by all healthcare professionals. Only 4,8% of the samples were taken by nurses, 62,7% came from medical centers. The majority of the ADR were not considered a serious disease (78%). The most frequently adverse drug reactions reported by nurses were local reactions. The patients most involved were children and vaccines were the most reported drugs (58,3%), followed by the intravenous contrast agents used in diagnostic tests. Conclusions: Nurses report very few cases to SEFV-H and are mostly related to the administration of vaccines and are sent by nurses working in the out-of-hospital setting. Most cases are not serious and usually report known adverse reactions to the suspected drug. This observed under-notification raises the need to promote increased pharmacovigilance training among these notifying nurses so that they can continue to report, and also for those who do not do so in their daily practice, so that they can begin to do so.(AU)


Assuntos
Humanos , Feminino , Papel do Profissional de Enfermagem , Enfermeiras e Enfermeiros , Farmacovigilância , Segurança do Paciente , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Notificação , Enfermagem , Espanha , Estudos Retrospectivos , Epidemiologia Descritiva
9.
Enferm Clin (Engl Ed) ; 31(6): 363-370, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34756240

RESUMO

OBJECTIVE: This study aimed to gain knowledge of the nurses' involvement in the spontaneous report of suspected adverse drug reactions (ADR) in the Spanish Pharmacovigilance System for Medicinal Products for Human Use (SEFV-H), describing the principal characteristics of the reported cases, identifying points of improvement. METHODS: A descriptive observational retrospective study was based on the data from FEDRA, the database created by the SEFV-H. The sample taken was the spontaneous adverse drug reactions reported to SEFV-H by nurses during the first 6 months of the 2018. RESULTS: Complete data was provided by 6,370 suspicions of ADR reported to SEFV-H by all healthcare professionals. Only 4,8% of the samples were taken by nurses, 62,7% came from medical centers. The majority of the ADR were not considered a serious disease (78%). The most frequently adverse drug reactions reported by nurses were local reactions. The patients most involved were children and vaccines were the most reported drugs (58,3%), followed by the intravenous contrast agents used in diagnostic tests. CONCLUSIONS: Nurses report very few cases to SEFV-H and are mostly related to the administration of vaccines and are sent by nurses working in the out-of-hospital setting. Most cases are not serious and usually report known adverse reactions to the suspected drug. This observed under-notification raises the need to promote increased pharmacovigilance training among these notifying nurses so that they can continue to report, and also for those who do not do so in their daily practice, so that they can begin to do so.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Criança , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Humanos , Farmacovigilância , Estudos Retrospectivos , Espanha
10.
Artigo em Inglês | MEDLINE | ID: mdl-34639769

RESUMO

BACKGROUND: The COVID-19 pandemic has contributed to the occurrence of work-related stress on nursing staff. Being resilience an essential element to countering adversity. The aim of the study was to assess burnout syndrome as well as resilience in hospital-care nurses during the first outbreak of the COVID-19 pandemic. METHODS: A cross-sectional descriptive study of burnout syndrome and resilience of 101 nurses during the first COVID-19 outbreak. The Maslach Burnout Inventory and the Scale of Resilience of Connor-Davidson were used. RESULTS: The burnout average score was 74.35 ± 12.78 points, and resilience was 27.94 ± 5.84. Temporary nurses reached a lower average score for the emotional fatigue dimension (23.80 ± 10.39 points) p < 0.05. The emotional fatigue dimension correlated adversely with the average score of resilience (r = -0.271; p < 0.001). CONCLUSIONS: The level of burnout in nurses was high, being higher on those who took care of COVID-19 patients. Resilient nurses were able to better cope with stressful situations.


Assuntos
Esgotamento Profissional , COVID-19 , Enfermeiras e Enfermeiros , Resiliência Psicológica , Esgotamento Profissional/epidemiologia , Estudos Transversais , Humanos , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
11.
Sci Rep ; 11(1): 19923, 2021 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620931

RESUMO

Bleeding in non-steroidal anti-inflammatory drug (NSAID) users limited their prescription. This first multicenter full case-control study (325 cases and 744 controls), explored the association of e-NOS intron 4 variable number tandem repeat (VNTR) polymorphism with upper gastrointestinal hemorrhage (UGIH) in NSAID exposed and unexposed populations and assessed any interaction between this polymorphism and NSAIDs. NSAID users carrying e-NOS intron 4 wild type genotype or VNTR polymorphism have higher odds of UGIH than those unexposed to NSAIDs [Odds Ratio (OR): 6.62 (95% Confidence Interval (CI): 4.24, 10.36) and OR: 5.41 (95% CI 2.62, 11.51), respectively], with no effect modification from VNTR polymorphism-NSAIDs interaction [Relative Excess Risk due to Interaction (RERI): -1.35 (95% CI -5.73, 3.03); Synergism Index (S): 0.77 (95% CI 0.31, 1.94)]. Similar findings were obtained for aspirin exposure. Non-aspirin NSAID users who carry e-NOS intron 4 VNTR polymorphism have lower odds of UGIH [OR: 4.02 (95% CI 1.85, 8.75) than those users with wild type genotype [OR: 6.52 (95% CI 4.09, 10.38)]; though the interaction estimates are not statistically significant [RERI: -2.68 (95% CI -6.67, 1.31); S: 0.53 (95% CI 0.18, 1.55)]. This exploratory study suggests that the odds of UGIH in NSAID or aspirin users does not modify according to patient´s e-NOS intron 4 genotype.


Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Suscetibilidade a Doenças , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/etiologia , Repetições Minissatélites , Óxido Nítrico Sintase Tipo III/genética , Polimorfismo Genético , Adulto , Idoso , Alelos , Anti-Inflamatórios não Esteroides/uso terapêutico , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Íntrons , Masculino , Pessoa de Meia-Idade , Fatores de Risco
12.
Sci Rep ; 11(1): 15304, 2021 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-34315947

RESUMO

Weight gain is a frequent and severe adverse reaction in patients taking antipsychotics. The objective was to further investigate in a natural setting influential risk factors associated with clinically significant weight gain. An observational follow-up study was conducted. Patients when initiating treatment with whatever antipsychotic were included; a structured questionnaire was applied at baseline, 3 and 6 months later; a blood sample was obtained. In a nested case-control approach, patients with an increase ≥ 7% of their initial weight were considered as cases, the remaining, as controls. The results showed that, out of 185 patients, 137 completed the 6-month follow-up (cases, 38; controls, 99). Weight gain gradually and significantly increased in cases (baseline, 65.0 kg; 6 months, 74.0 kg) but not in controls (65.6 kg and 65.8 kg, respectively). Age (adjusted OR = 0.97, 95% CI = 0.96-0.99, p = 0.004), olanzapine (adjusted OR = 2.98, 95% CI = 1.13-7.80, p = 0.027) and quetiapine (adjusted OR = 0.25, 95% = 0.07-0.92, p = 0.037) significantly associated with weight gain. An association was also found for the CNR1 (rs1049353) and INSIG2 (rs7566605) polymorphisms. In conclusion, an increased risk of antipsychotics-induced weight gain was observed for younger age and olanzapine, and a relative lower risk for quetiapine. A potential role of CNR1 rs1049353 and INSIG2 rs7566605 polymorphisms is suggested.


Assuntos
Antipsicóticos/efeitos adversos , Peptídeos e Proteínas de Sinalização Intracelular/genética , Proteínas de Membrana/genética , Polimorfismo Genético , Receptor CB1 de Canabinoide/genética , Aumento de Peso/efeitos dos fármacos , Adulto , Estudos de Casos e Controles , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
13.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33531221

RESUMO

OBJECTIVE: This study aimed to gain knowledge of the nurses' involvement in the spontaneous report of suspected adverse drug reactions (ADR) in the Spanish Pharmacovigilance System for Medicinal Products for Human Use (SEFV-H), describing the principal characteristics of the reported cases, identifying points of improvement. METHODS: A descriptive observational retrospective study was based on the data from FEDRA, the database created by the SEFV-H. The sample taken was the spontaneous adverse drug reactions reported to SEFV-H by nurses during the first 6 months of the 2018. RESULTS: Complete data was provided by 6,370 suspicions of ADR reported to SEFV-H by all healthcare professionals. Only 4,8% of the samples were taken by nurses, 62,7% came from medical centers. The majority of the ADR were not considered a serious disease (78%). The most frequently adverse drug reactions reported by nurses were local reactions. The patients most involved were children and vaccines were the most reported drugs (58,3%), followed by the intravenous contrast agents used in diagnostic tests. CONCLUSIONS: Nurses report very few cases to SEFV-H and are mostly related to the administration of vaccines and are sent by nurses working in the out-of-hospital setting. Most cases are not serious and usually report known adverse reactions to the suspected drug. This observed under-notification raises the need to promote increased pharmacovigilance training among these notifying nurses so that they can continue to report, and also for those who do not do so in their daily practice, so that they can begin to do so.

16.
Front Pharmacol ; 11: 860, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32655394

RESUMO

Background: Despite the wide benefits of aspirin and its cost-effectiveness, aspirin prescriptions have been reduced due to idiosyncratic responses in susceptible individuals. Low-dose aspirin and single-nucleotide polymorphisms (SNPs) are independently associated with increased risk of gastrointestinal hemorrhage; however, to-date, no studies investigated the SNP-aspirin interaction effect on upper gastrointestinal hemorrhage (UGIH). Therefore, we aimed to evaluate the role of 25 SNPs in multiple genes involved in platelet activation, angiogenesis and inflammatory response in aspirin-related UGIH. Methods: A multicenter, full case-control study was conducted in patients exposed and unexposed to aspirin. Three hundred twenty-six cases diagnosed with UGIH were matched with 748 controls (1:3) by age, gender, health center, and recruitment date. Only adults of European origin were included. Participants were stratified by aspirin exposure and genotype [(Aspirin(-), wild-type), (Aspirin(+), wild-type), (Aspirin(+), genetic variation), (Aspirin(-), genetic variation)]. For each SNP, the Odds Ratio of UGIH and their 95% confidence intervals were estimated in each subgroup by using the generalized linear mixed models for dependent binomial variables. SNP-aspirin interaction effect was estimated through Relative Excess Risk due to Interaction (RERI) measures. Results: We observed two categories of SNPs that might modify the risk magnitude of UGIH in aspirin consumers. Seven SNPs (rs1387180 A > G, rs2238631 T > C, rs1799964 T > C, rs5050 T > C/T > G, rs689466 T > C, rs1799983 T > A/T > G, and rs7756935 C > A) were "positive modifiers" associated with an excess of risk from aspirin exposure and carrying that genetic variation (1.75 ≤ RERI ≤ 4.95). On the contrary, the following nine SNPs (rs2243086 G > T, rs1131882 G > A, rs4311994 C > T, rs10120688 G > A, rs4251961 T > C, rs3778355 G > C, rs1330344 C > T, rs5275 A > G/A > T, and rs3779647 C > T) were "negative modifiers" and associated with a reduced risk in aspirin users (-2.74 ≤ RERI ≤ -0.95). Conclusion: This preliminary study suggests that polymorphisms in genes involved in platelets activity, angiogenesis and inflammatory response might modify the risk of aspirin-related UGIH. Further studies with larger sample size and in different populations are needed to confirm our findings. If confirmed, this might have great impact on public health, thanks to aspirin's prophylactic properties in diseases of high incidence and severity.

18.
Metas enferm ; 18(7): 65-69, sept. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-143125

RESUMO

Una de las principales innovaciones que se debe llevar a cabo para implementar la actual reforma de la universidad española se encuentra en el protagonismo de los estudiantes y las metodologías que promuevan el aprendizaje autónomo y, también, colaborativo. En este artículo se presenta el diseño y construcción de un blog educativo por el profesorado y el alumnado de la asignatura Enfermería en Salud Sexual y Reproductiva en 2º Grado en Enfermería de la Universidad de Valladolid (España), que tiene la finalidad de desarrollar estrategias didácticas novedosas para compartir ideas o como un instrumento de soporte para contenidos curriculares. Los weblogs, blogs o bitácoras son herramientas de gran utilidad en educación, son gratuitos y fáciles de usar. Complementan la enseñanza presencial, permiten el aprendizaje colaborativo, sirven como buscadores a través de enlaces específicos y promueven la interacción entre los profesores y los estudiantes con sus comentarios


One of the main innovations which must be conducted in order to implement the current reform in the Spanish University consists in the main role played by students and the methodologies which promote independent as well as cooperative learning. In this article, we present the design and building of an educational blog by the professors and students of the Nursing in Sexual and Reproductive Health subject in the 2nd Nursing Degree of the University of Valladolid (Spain), with the objective of developing innovative learning strategies to share ideas or as a supporting tool for educational contents. Weblogs, blogs or logs are very useful tools in education, they are free and easy to use. They complement face-to-face teaching, allow collaborative learning, are useful search engines through specific links, and they promote interaction between professors and students with their comments


Assuntos
Humanos , Educação em Enfermagem/tendências , Blogging/organização & administração , Estudantes de Enfermagem , Materiais Educativos e de Divulgação , Desenvolvimento Tecnológico
19.
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1035256

RESUMO

Resumen:


El sistema de notificación voluntaria de reacciones adversas es el método más universal de farmacovigilancia y consiste en la recogida (y posterior comunicación) de aquellas reacciones no deseadas que pueden aparecer tras el uso de los fármacos en humanos. Se implantó en 1982 en España y en 1986 en Castilla y León. El objetivo de este estudio es conocer la participación enfermera en este campo. Se ha realizado un estudio observacional retrospectivo con búsquedas de las notificaciones realizadas en el periodo de 1986 y el 18 de noviembre de 2010 en la Comunidad Autónoma de Castilla y León en FEDRA 2.0 (Farmacovigilancia Española Datos de Reacciones Adversas). Se han recibido un total de 7.537 notificaciones en este periodo, de las cuales 237 (3%) han sido realizadas por enfermeras. Los años 2009, 2004 y 2002, y las provincias de Ávila, Palencia y Valladolid fueron las que más actividad enfermera tuvieron; siendo mayor en los centros de salud y los servicios de emergencias. En conclusión, el papel de las enfermeras en la farmacovigilancia de Castilla y León ha existido y existe, pero es mínimo. Es necesario reforzar la formación sobre este tema y realizar campañas de sensibilización.


Assuntos
Humanos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Farmacovigilância , Pesquisa em Enfermagem , México
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