First use of silicon carbide detectors with graphene-enhanced contacts for medical dosimetry.

Silicon Carbide (SiC) is a radiation hard wide bandgap semiconductor, which makes it an interesting alternative for radiation detector fabrication, with potential applications such as High Energy Physics, synchrotron and radiotherapy instrumentation. In addition, by reducing the amount of metal over the active area of said detectors (typically used for electrical connectivity with the implant of the pn-junction) unwanted effects from secondary interactions which can affect the accuracy of the measurement can be diminished, essential to meet the medical standards of precision. In this article, the use of epitaxially-grown graphene is explored as an alternative to metallic contacts with these prototypes. To this end, the first prototypes of SiC diodes with epitaxial graphene contacts were produced at IMB-CNM for radiation detection,along with reference devices. In order to characterise the feasibility of the technology in the medical application, the dose rate linearity of the SiC device with graphene was measured in a radiotherapy Linac in the dose rate range of 1-6 Gy/min. The response of the device was compared to that observed on devices with similar geometries reported elsewhere. To fully characterise the devices, the same exercise was repeated in a laboratory X-ray tube. Under the later set-up, the prototype is compared against a device with a fully metallised active region.

A web-enabled, school-based intervention for bullying prevention (LINKlusive): a cluster randomised trial.

Background: There is a need for more sustainable interventions and for assessing the effectiveness of school-based universal anti-bullying programmes in vulnerable populations. We assessed the efficacy of a multicomponent, web-enabled, school-based intervention that aims to improve school climate and reduce bullying (LINKlusive) relative to conventional practices (control condition). Methods: We conducted a cluster randomised controlled trial in primary and secondary schools in Madrid, Spain. The primary outcome measure was peer-reported bullying victimisation after the 12-week intervention (study endpoint). We analysed data using longitudinal mixed-effects models. The trial was registered with the ISRCTN registry (15719015). Findings: We included 20 schools (10 in each group); 6542 students participated at baseline; 6403 were assessed at study endpoint. After the intervention, there was a statistically significant reduction in bullying victimisation in both the intervention (OR 0.61, 95% CI [0.41, 0.90]) and control groups (OR 0.69, 95% CI [0.51, 0.92]), with no evidence of differences in the whole sample (OR 0.89, 95% CI [0.58, 1.36]; aOR 0.89, 95% CI [0.58, 1.37]). Subgroup analyses showed a statistically significant effect of LINKlusive on bullying victimisation in primary education (aOR 0.68, 95% CI [0.47, 0.98]). In students with peer-reported bullying victimisation at baseline, LINKlusive showed a statistically significant effect on depression (-1.43, 95% CI [-2.46, -0.40], adjusted standardised mean difference (SMD) -0.41) and quality of life (2.18, 95% CI [0.80, 3.56], adjusted SMD 0.45). Interpretation: LINKlusive could be effective in reducing bullying victimisation in primary school students. Sustainable whole-school interventions to promote mental health and reduce risk factors are warranted to improve outcomes in young people, especially in the early years of education. Funding: Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation.

Trade-off between thermal preference and sperm maturation in a montane lizard.

Temperature is a key abiotic factor that influences performance of several physiological traits in ectotherms. Organisms regulate their body temperature within a range of temperatures to enhance physiological function. The capacity of ectotherms, such as lizards, to maintain their body temperature within their preferred range influences physiological traits such as speed, various reproductive patterns, and critical fitness components, such as growth rates or survival. Here, we evaluate the influence of temperature on locomotor performance, sperm morphology and viability in a high elevation lizard species (Sceloporus aeneus). Whereas maximal values for sprint speed coincides with field active and preferred body temperature, short-term exposure at the same range of temperatures produces abnormalities in sperm morphology, lower sperm concentration and diminishes sperm motility and viability. In conclusion, we confirmed that although locomotor performance is maximized at preferred temperatures, there is a trade-off with male reproductive attributes, which may cause infertility. As a consequence, prolonged exposure to preferred temperatures could threaten the persistence of the species through reduced fertility. Persistence of the species is favored in environments with access to cooler, thermal microhabitats that enhance reproductive parameters.

Ansiedad, depresión y soledad en cuidadores de personas con enfermedad crónica / Anxiety, depression and loneliness in caregivers of people with chronic illness

Objetivo principal: Determinar la relación entre ansiedad, depresión y soledad en cuidadores familiares de adultos mayores con enfermedades crónicas. Metodología: Diseño descriptivo correlacional. Se utilizó la Escala hospitalaria de ansiedad y depresión (α=.83) y la escala de Soledad (α=.95). Se hizo un cálculo de tamaño de muestra con programa G-Power 3.1.9.7 y se aplicó un muestreo a conveniencia. Se analizó con estadística descriptiva e inferencial, como Pearson y chi2. Resultados principales: Participaron 178 cuidadores familiares con una m de 45 años. Se encontró relación de la edad con la percepción de soledad (r=-.200) y el tiempo del cuidado con la puntuación de depresión (r=-.199) y ansiedad (r=-.179). Conclusión principal: Se encontró que, a mayor edad del cuidador, mayor es la percepción de soledad, y a mayor tiempo de cuidado, menor es la depresión y ansiedad, permitiendo implementar futuros programas de atención para mejorar la calidad de vida de los cuidadores.(AU)

Objective: To determine the relationship between anxiety, depression and loneliness in family caregivers of older adults with chronic diseases. Methodology: Correlational descriptive design. The Hospital Anxiety and Depression Scale (α=.83) and the Loneliness Scale (α=.95) were used. A sample size calculation was made with the G-Power 3.1.9.7 program and a convenience sample was applied. It was analyzed with descriptive and inferential statistics, such as Pearson and chi2. Main results: 178 family caregivers with an M of 45 years participated. A relationship was found between age and perception of loneliness (r=-.200) and care time with depression (r=-.199) and anxiety (r=-.179) scores. Main conclusion: It was found that, the older the caregiver, the greater the perception of loneliness and the longer the care time, the lower the depression and anxiety, allowing the implementation of future care programs to improve the quality of life of caregivers.(AU)

Efficacy of a Web-Enabled, School-Based, Preventative Intervention to Reduce Bullying and Improve Mental Health in Children and Adolescents: Study Protocol for a Cluster Randomized Controlled Trial.

Introduction: Bullying is a major preventable risk factor for mental disorders. Available evidence suggests school-based interventions reduce bullying prevalence rates. This study aims to test the efficacy of a web-enabled, school-based, multicomponent anti-bullying intervention to prevent school bullying and to assess its effects on mental health and quality of life. Methods and analysis: Cluster randomized controlled trial conducted in 20 publicly funded primary and secondary schools in Madrid, Spain. Schools are randomly allocated to either the intervention arm (n = 10) or conventional practices arm (n = 10). The web-enabled intervention (LINKlusive) lasts ~12 weeks and consists of three main components: (i) an online training program for teachers and parents, (ii) a web-guided educational program for students, focusing on promoting respect for diversity, empathy, and social skill development, and (iii) a web-guided, teacher-delivered, targeted intervention program for bullying situations identified based on peer-support strategies and individual intervention for those involved (i.e., bullying victims and perpetrators). The primary objective is to compare differences between peer-reported bullying victimization in the intervention and control arms at the end of the intervention. Secondary outcome measures are additional measures of bullying victimization and perpetration, mental health symptoms, self-esteem, and quality of life. A follow-up assessment is conducted 1 year after the end of the intervention. Treatment effects will be tested using multilevel mixed models, adjusting for school-, classroom-, and student-related covariates. Considering the increased bullying rates in children with special educational needs, a specific subgroup analysis will test the efficacy of the intervention on bullying prevalence, mental health, and quality of life in this particularly vulnerable population. Ethics and Dissemination: The Deontology Commission of the School of Psychology, Universidad Complutense in Madrid, Spain reviewed the study protocol and granted ethical approval on 21st January 2019. The results of the trial will be disseminated in relevant peer-reviewed journals and at conferences in the field. Trial Registration Number: ISRCTN15719015.

Complicación clínica inusual: isquemia aguda de miembro inferior causada por osteocondroma tibial / Unusual clinical complication: Acute lower limb ischemia caused by a tibial osteochondroma

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Interactions between thermoregulatory behavior and physiological acclimatization in a wild lizard population.

Although the importance of thermoregulation and plasticity as compensatory mechanisms for climate change has long been recognized, they have largely been studied independently. Thus, we know comparatively little about how they interact to shape physiological variation in natural populations. Here, we test the hypothesis that behavioral thermoregulation and thermal acclimatization interact to shape physiological phenotypes in a natural population of the diurnal lizard, Sceloporus torquatus. Every month for one year we examined thermoregulatory effectiveness and changes in the population mean in three physiological parameters: cold tolerance (Ctmin), heat tolerance (Ctmax), and the preferred body temperature (Tpref), to indirectly assess thermal acclimatization in population means. We discovered that S. torquatus is an active thermoregulator throughout the year, with body temperature varying little despite strong seasonal temperature shifts. Although we did not observe a strong signal of acclimatization in Ctmax, we did find that Ctmin shifts in parallel with nighttime temperatures throughout the year. This likely occurs, at least in part, because thermoregulation is substantially less effective at buffering organisms from selection on lower physiological limits than upper physiological limits. Active thermoregulation is effective at limiting exposure to extreme temperatures during the day, but is less effective at night, potentially contributing to greater plasticity in Ctmin than Ctmax. Importantly, however, Tpref tracked seasonal changes in temperature, which is one the factors contributing to highly effective thermoregulation throughout the year. Thus, behavior and physiological plasticity do not always operate independently, which could impact how organisms can respond to rising temperatures.

Correlação entre exercício físico e qualidade de vida em pacientes com doença de Alzheimer / Correlation of physical exercise and quality of life in patients with Alzheimer's disease

O aumento da expectativa de vida é crescente e, concomitante a isto, há a valorização de algumas patologias, que acompanham a senescência − dentre elas as demências. No Brasil, 54,15% dos pacientes com demência foram diagnosticados com doença de Alzheimer, que é um distúrbio neurodegenerativo. A terapia medicamentosa apresenta benefícios limitados, sendo importante uma busca de terapias adjuvantes, para melhorar a qualidade de vida e retardar a institucionalização. O objetivo deste estudo foi correlacionar os benefícios do exercício físico para o paciente com doença de Alzheimer, e a melhora na qualidade de vida e na evolução do doente. Foi realizada uma revisão bibliográfica de artigos indexados nas bases SciELO, LILACS e PubMed, publicados entre os anos de 2010 e 2016, utilizando os descritores "doença de Alzheimer" e "exercício físico", pesquisados em português e inglês. Foram considerados para análise artigos redigidos em língua portuguesa, inglesa e espanhola. Foram encontrados 38 artigos no PubMed, 5 no LILACS e 4 na SciELO, sendo 28 selecionados, por sua maior relevância ao tema. O exercício físico possui efeito neuroprotetor na função cognitiva, por provocar redistribuição do fluxo sanguíneo cerebral, ação antioxidante de enzimas de reparação e citocinas pró-inflamatórias, degradação de placas amiloides, aumento do metabolismo e da síntese de neurotransmissores, resultando em mudanças cerebrais benéficas − estrutural e funcionalmente. Exercícios físicos demonstraram bons resultados na preservação da função cognitiva e funcional desses pacientes. Porém, ainda são necessários mais estudos acerca do tema, pelo fato de as pesquisas existentes apresentarem algumas limitações, principalmente quanto à amostragem. Este tema apresenta alta relevância e impacto da doença de Alzheimer nos pacientes.(AU)

Increased life expectancy is growing and, with it, some pathologies accompanying senescence, such as dementia, are more valued. In Brazil, 54.15% of patients with dementia were diagnosed with Alzheimer's Disease (AD), which is a neurodegenerative disorder. Drug therapy has limited benefits, and a search of adjuvant therapies to improve the quality of life and delay institutionalization is important. The objective of this study was to correlate the benefits of physical exercise in patients with Alzheimer's Disease, and to improve the quality of life and evolution of these patients. Literature review of articles indexed in SciELO, Lilacs and PubMed databases, published between 2010-2016, using the key words "Alzheimer's disease" and "physical exercise" was performed. The articles written in Portuguese, English or Spanish were considered. Five articles were found in Lilacs, 38 in PubMed and 4 in Scielo, with 28 being selected due to their relation with the theme. Physical exercise has a neuroprotective effect on cognitive function by causing redistribution of cerebral blood flow, antioxidant action of repair enzymes, and pro-inflammatory cytokines, degradation of amyloid plaques, increased metabolism and synthesis of neurotransmitters, resulting in beneficial structural and functional brain changes. Physical exercises have shown good results in these patients' cognitive and functional preservation and/or improvement. However further studies about the subject are necessary because the existing studies have some limitations, mainly regarding sampling. This topic will have high relevance and impact of Alzheimer's Disease on patients.(AU)

Thermal ecology and activity patterns of six species of tropical night lizards (Squamata: Xantusiidae: Lepidophyma) from Mexico.

Activity patterns in ectotherms rely on the structure of the thermal environment and thermoregulatory opportunities during activity periods. A dichotomy between diurnal and nocturnal ectotherms is not clear in every case, and temperature can directly affect the daily activity period in these organisms during both photophase and scotophase. In the present study we evaluate the thermal ecology of six tropical night lizards (genus Lepidophyma) from Mexico. Our results indicate a thermoconformer strategy in most of the studied species. In these species, thermal tolerances are associated with environmental temperatures to which they are exposed. Furthermore, thermal quality of the environment directly determines the daily activity period. Therefore, we argue that diurnal activity in Lepidophyma species is determined by local thermal conditions.

Development and clinical characterization of a novel 2041 liquid-filled ionization chambers array for high-resolution verification of radiotherapy treatments.

PURPOSE: The aim of this study was to present a novel 2041 liquid-filled ionization chamber array for high-resolution verification of radiotherapy treatments. MATERIALS AND METHODS: The prototype has 2041 ionization chambers of 2.5 × 2.5 mm2 area filled with isooctane. The detection elements are arranged in a central square grid of 43 × 43, totally covering an area of 107.5 × 107.5 mm2 . The central inline and cross-line are extended to 227 mm and the diagonals to 321 mm to be able to perform profile measurements of large fields. We have studied stability, pixel response uniformity, dose rate dependence, depth and field size dependence and anisotropy. We present results for output factors, tongue-and-groove, garden fence, small field profiles, irregular fields, and verification of dose planes of patient treatments. RESULTS: Comparison with other detectors used for small field dosimetry (SFD, CC13, microDiamond) has shown good agreement. Output factors measured with the device for square fields ranging from 10 × 10 to 100 × 100 mm2 showed relative differences within 1%. The response of the detector shows a strong dependence on the angle of incident radiation that needs to be corrected for. On the other hand, inter-pixel relative response variations in the 0.95-1.08 range have been found and corrected for. The application of the device for the verification of dose planes of several treatments has shown gamma passing rates above 97% for tolerances of 2% and 2 mm. The verification of other clinical fields, like small fields and irregular fields used in the commissioning of the TPS, also showed large passing rates. The verification of garden fence and tongue-and-groove fields was affected by volume-averaging effects. CONCLUSIONS: The results show that the liquid filled ionization chamber prototype here presented is appropriate for the verification of radiotherapy treatments with high spatial resolution. Recombination effects do not affect very much the verification of relative dose distributions. However, verification of absolute dose distributions may require normalization to a radiation field which is representative of the dose rate of the treatment delivered.

Timo ectópico cervical: Presentación de un caso / Ectopic Cervical Thymus: A Case Report

Introducción: El timo ectópico es una patología poco frecuente que se caracteriza por una masa en el cuello no dolorosa, que puede ser quística o sólida, resultado de una alteración en el proceso de migración de los primordios del timo durante la gestación. La adecuada interpretación, dentro del amplio espectro de diagnósticos diferenciales, es muy importante para evitar manejos invasivos innecesarios. Presentación de caso: Se trata de un niño de 8 meses, sin antecedentes relevantes, con abultamiento en la región submandibular derecha, no dolorosa, a quien en la exploración mediante ecografía y resonancia magnética se le encontraron características de imagen idénticas al timo ortotópico, lo que constituye un raro caso de timo ectópico sólido. Posterior a la cirugía, el resultado de patología correspondió a timo ectópico. Discusión: El timo es un órgano ubicado en el mediastino anterosuperior que tiene un papel importante en la inmunidad mediada por células. Proviene embriológicamente del tercer y cuarto arcos braquiales y migra a través del conducto timofaríngeo desde el ángulo de la mandíbula hasta la unión cérvico-mediastínica. El tejido tímico ectópico puede ocurrir en cualquier punto a lo largo del conducto timofaríngeo. La incidencia no es claramente conocida. Es más común en el cuello izquierdo, quístico, en hombres, entre los 2 y 13 años y unilateral. La apariencia normal del timo, y por ende de los timos ectópicos sólidos, es exactamente igual en las diferentes modalidades de imagen. Los diagnósticos diferenciales incluyen quistes del conducto tirogloso, quistes branquiales, tumor dermoide, hemangioma, fibromatosis colli, teratoma, linfoma y neuroblastoma, entre otros. Conclusión: El timo ectópico es una lesión cervical rara que simula patología, por lo cual es importante entender las características radiológicas que permitan un adecuado diagnóstico para prevenir intervenciones y cirugías innecesarias.

Introduction: Ectopic thymus is a rare disease characterized by a non-painful mass on the neck, which may be cystic or solid, resulting from an alteration in the process of migration of the thymus primordia during gestation. Proper interpretation, within the broad spectrum of differential diagnoses, is very important to avoid unnecessary invasive management. Case presentation: We present the case of an 8 months-old boy, with no relevant history, with bulging in the right submandibular region, not painful, that in the exploration by ultrasound and magnetic resonance imaging characteristics were found identical to the thymus orthotics, constituting a rare case of solid ectopic thymus, which was taken to surgery. The pathology corresponded to ectopic thymus. Discussion: The thymus is an organ located in the anterosuperior mediastinum that plays an important role in cell-mediated immunity. It develops embryologically from the third and fourth brachial arches and migrates through the pharyngeal thymus conduit from the angle of the mandible to the mediastinal cervical junction. Ectopic thymic tissue can occur at any point along the pharyngeal thymus conduit. The incidence is not clearly known. They are more common in the left neck, cystic, in men, between 2 and 13 years and of unilateral presentation. The normal appearance of the thymus, and therefore of the solid ectopic thymus, is exactly the same in the different imaging modalities. Differential diagnoses include thyroglossal duct cysts, gill cysts, dermoid tumor, hemangioma, fibromatosis colli, teratoma, lymphoma and neuroblastoma, among others. Conclusion: The ectopic thymus is a rare cervical lesion that simulates pathology, so it is important to understand the radiological characteristics that allow an adequate diagnosis to prevent interventions and unnecessary surgeries.

Mothers massaging their newborns with lotion versus no lotion enhances mothers' and newborns' sleep.

Sleep is frequently interrupted in newborns and their mothers. Massage therapy is noted to facilitate sleep in adults and infants. Infant massage has also been more effective with oil versus no oil. In this study 76 mothers of newborns were randomly assigned to a massage with lotion versus a massage without lotion group and a non-massage control group. The mothers were then taught a simple newborn massage and were asked to massage their newborns daily for 15min at bedtime for one month. The Brief Infant Sleep Questionnaire was adapted for newborns and for mothers, and the mothers completed the questionnaires on their newborns' and their own sleep behaviors (the same behaviors for both mothers and newborns). The 3 groups were compared on the mothers' and their newborns' sleep behavior changes from birth to one month. By the last day of the study, the lotion massage group versus the other two groups showed a shorter latency to sleep and longer sleep for the mothers and fewer nightwakings and longer sleep for their infants. This may relate to the lotion group mothers massaging their infants more frequently as the number of massages was correlated with the total time sleeping and negatively correlated with nightwakings for both the mothers and the infants on the last day of the study. And, the mothers' and the infants' sleep behaviors were significantly correlated.

Knee arthritis pain is reduced and range of motion is increased following moderate pressure massage therapy.

BACKGROUND: The literature on massage therapy effects on knee pain suggests that pain was reduced based on self-report, but little is known about range of motion (ROM) effects. METHODS: Medical School staff and faculty who had knee arthritis pain were randomly assigned to a moderate pressure massage therapy or a waitlist control group (24 per group). Self-reports included the WOMAC (pain, stiffness and function) and the Pittsburgh Sleep Quality Index. ROM and ROM-related pain were assessed before and after the last sessions. RESULTS: The massage group showed an immediate post-massage increase in ROM and a decrease in ROM-associated pain. On the last versus the first day of the study, the massage group showed greater increases in ROM and decreases in ROM-related pain as well as less self-reported pain and sleep disturbances than the waitlist control group. DISCUSSION: These data highlight the effectiveness of moderate pressure massage therapy for increasing ROM and lessening ROM-related pain and long-term pain and sleep disturbances.

[Glomus tumour of the lung: a case report and literature review]. / Tumor glómico en pulmón: reporte de un caso y revisión bibliográfica.

BACKGROUND: Glomus tumours are neoplasms arising from cells of the neuromyoarterial glomus bodies, which almost always occur in a subungual location. A lung location is extremely rare, with few cases reported in the literature. CLINICAL CASE: The case is presented of a 33 year-old male, with non-productive cough, dyspnoea at rest, intermittent fever, and mild pain in rib cage. A chest radiograph showed a consolidation in the left lung, and computed tomography revealed a lesion in the hilum that extended to the bronchus of the lingula obstructing, and causing post-obstructive pneumonia. A biopsy was obtained by rigid bronchoscopy biopsy, which showed a well circumscribed tumour constituted by intermediate-sized cells, and abundant cytoplasm that are arranged in a pattern surrounding numerous thin-walled blood vessels, with no pleomorphism, significant mitotic activity or necrosis. Immunohistochemistry revealed diffuse positivity with smooth muscle actin, vimentin, caldesmon; focal reactivity with desmin and CD117, CD34 highlights the vascular pattern. Ki67 proliferation rate was 1%. Synaptophysin, EMA and cytokeratin cocktail were negative, making the diagnosis of glomus tumour. CONCLUSIONS: Glomus tumours are rare neoplasms that usually appear in the dermis and subcutaneous tissue, where it is common to find glomus bodies. Occasionally glomus tumours can occur in extra-cutaneous sites such as the gastrointestinal tract, bone and respiratory system, with this case being a new case of rare lung location.

Neck arthritis pain is reduced and range of motion is increased by massage therapy.

BACKGROUND: The literature on the effects of massage therapy on neck arthritis pain is mixed depending on the dose level, and it is also based on self-report. In the present study an attempt was made to enhance the effects of weekly massage therapy by having the participants massage themselves daily. And in addition to self-reports on pain, range of motion (ROM) and the associated ROM pain were assessed before and after the first massage session and pre-post the last session one month later. METHODS: Staff and faculty members at a medical school who were eligible for the study if they had neck arthritis pain were randomly assigned to a massage or a waitlist control group (N = 24 per group). The massage group received moderate pressure massages weekly by a massage therapist plus daily self-massages. The waitlist control group received the same schedule massages one month after being control subjects. RESULTS: The massage group showed significant short-term reductions after the first and last day massages in self-reported pain and in ROM-associated pain as well as an increase in ROM. Comparisons between the massage group (N = 23) and the control group (N = 14) on the last versus the first day data suggested significantly different changes including increased ROM and reduced ROM-associated pain for the massage group and reduced ROM and increased ROM-associated pain for the control group. These changes occurred specifically for flexion and right and left lateral flexion motions. DISCUSSION: These data highlight the importance of designing massage therapy protocols that target the most affected neck muscle groups and then assessing range of motion and related pain before and after the massage therapy. Comparisons with other studies also suggest that moderate pressure may contribute to the massage effects, and the use of daily self-massages between sessions may sustain the effects and serve as a cost-effective therapy for individuals with neck arthritis pain.

Teoría del ser humano unitario para el cuidado del paciente con cáncer gástrico y síndrome anémico severo / Unitary human beings theory in the care of adult patients with gastric cancer and severe anemic syndrome

Resumen:

Con base en los supuestos de la teoría de Martha Rogers y el diseño de la guía de valoración con dominios y clases, se implemento el proceso de atención de enfermería a un paciente adulto con cáncer gástrico y síndrome anémico severo. Durante dicho proceso se privilegió la atención holística con la prioridad de otorgar cuidados centrados en el logro de resultados, a partir de la interrelación NANDA (la otrora North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification), y NIC (Nursing Interventions Classification). En la evaluación se identificó la mejora en la puntuación diana de sustancial a leve en el estatus del compromiso respiratorio y perturbación en el campo de la energía, así como en las dimensiones biopsicosocial y espiritual.

La experiencia permitió una mejor comprensión del paciente con cáncer como un ser humano unitario, así como un nuevo planteamiento sobre la toma de decisiones en el cuidado y en la aplicación de un pensamiento lateral para la resolución de problemas en la línea de la colaboración y coparticipación entre la familia, el paciente y la enfermera. En ese sentido, este artículo es una invitación a la reflexión en el actuar e interactuar como personas y como seres humanos únicos e indivisibles.

Abstract:

Based on the assumptions of the theory of Martha Rogers and the design of an assessment guide with domains and classes, the nursing care process to an adult patient with gastric cancer and severe anemic syndrome was implemented. During this process, holistic care was favored giving priority to the achievement of results, on the basis of the correlation between NANDA (before the North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification), NIC (Nursing Interventions Classification). In the evaluation, improvement was identified with change in the target score from substantial to mild in respiratory distress and disturbance in the energy field, as in the biopsychosocial and spiritual dimensions.

The experience allowed a better understanding of the cancer patient as a unitary human being and a new approach to decision-making in care and application of a lateral thinking to solve problems in collaboration and joint participation among family-patient-nurse. In this sense, this article is an invitation to reflect on the act and interact as individuals and as unique and indivisible human beings.

Massage therapy plus topical analgesic is more effective than massage alone for hand arthritis pain.

METHODS: 20 adults were randomly assigned to a massage therapy or a massage therapy plus a topical analgesic application group. Both groups received a weekly massage from a therapist and were taught self-massage (same procedure) to be done by each participant once daily over a four-week period. RESULTS: The massage plus topical analgesic group as compared to the massage group had greater improvement in hand function as measured by a digital hand exerciser following the first session and across the four-week period. That group also had a greater increase in perceived grip strength and a greater decrease in hand pain, depressed mood and sleep disturbances over the four-week period. Massage therapy has been effective for several pain syndromes including migraine headaches (Lawle and Cameron, 2006)), lower back pain (Hsieh et al., 2004), fibromyalgia (Kalichman, 2010), neck and shoulder pain (Kong et al., 2013), carpal tunnel syndrome (Elliott and Burkett, 2013), and pain related to upper limb arthritis (Field et al., 2013). The purpose of the current study was to determine whether applying a topical analgesic following massage might be more effective than massage alone in treating pain associated with hand arthritis.

Preterm infant weight gain is increased by massage therapy and exercise via different underlying mechanisms.

OBJECTIVE: To compare the effects of massage therapy (moderate pressure stroking) and exercise (flexion and extension of limbs) on preterm infants' weight gain and to explore potential underlying mechanisms for those effects. METHODS: Weight gain and parasympathetic nervous system activity were assessed in 30 preterm infants randomly assigned to a massage therapy group or to an exercise group. Infants received 10min of moderate pressure massage or passive flexion and extension of the limbs 3 times per day for 5days, and EKGs were collected during the first session to assess vagal activity. RESULTS: Both massage and exercise led to increased weight gain. However, while exercise was associated with increased calorie consumption, massage was related to increased vagal activity. CONCLUSION: Taken together, these findings suggest that massage and exercise lead to increased preterm infant weight gain via different underlying mechanisms.

Plasmocitoma extradural que simula un meningioma espinal: presentación de caso / Extradural Plasmacytoma Mimicking A Spinal Meningioma: A Case Report

La papilomatosis mamaria es un proceso benigno poco frecuente, asociado con el desarrollo de cáncer de mama. El limitado número de series y casos publicados no ha permitido definir algunos aspectos de su manejo y seguimiento. Este artículo presenta los casos de dos mujeres (uno de estos casos corresponde a la variante juvenil mamaria), seguidos por la discusión de dicha patología. Se hace énfasis en los hallazgos imagenológicos y en su correlación con la patología

Plasmacytomas are frequent extradural manifestations in patients with history of multiple myeloma (MM). We present a case of a patient with past history of MM, who consulted due to neurologic symptoms. The magnetic resonance showed an extradural mass with typical features of a spinal meningioma: a narrow canal and compressive myelopathy. Hystopathological analysis confirmed a plasmacytoma.