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1.
Gac. sanit. (Barc., Ed. impr.) ; 34(6): 608-614, nov.-dic. 2020. tab
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET1-6795

RESUMO

OBJETIVO: Explorar cuáles son las percepciones y las vivencias de las mujeres sordas en relación con la accesibilidad al Sistema de Salud Público Vasco (Osakidetza). Como objetivo secundario, explorar la experiencia de estas mujeres acerca de la violencia de género. MÉTODO: Estudio cualitativo con diseño exploratorio. La selección de las informantes se realizó mediante muestreo intencional. Se invitó a participar a mujeres sordas a través de la Federación de Personas Sordas de Euskadi. Se desarrollaron cuatro grupos de discusión entre octubre de 2013 y julio de 2014, con una duración media de 90-120 minutos. Estos grupos fueron grabados en vídeo para su posterior transcripción literal, en la que participó el Servicio de Intérpretes de Lengua de Signos de Euskadi. Se realizó un análisis temático. RESULTADOS: Surgen tres categorías principales: 1) sentimientos de discriminación y limitación del principio de autonomía; 2) barreras y facilitadores en la accesibilidad al sistema sanitario; y 3) vulnerabilidad de las mujeres sordas como consecuencia de la falta de comunicación. CONCLUSIONES: Las mujeres sordas continúan presentando dificultades para el acceso al sistema sanitario en nuestro contexto. Los resultados de este estudio pueden ser un punto de partida para el desarrollo de políticas sanitarias y de protocolos institucionales


OBJECTIVE: To explore what are the perceptions and experiences of deaf women in relation to accessibility to the Basque Public Health System (Osakidetza). As a secondary objective, explore the experience of these women about gender violence. METHOD: A qualitative study with exploratory design is developed. The selection of the informants was carried out through intentional sampling. Deaf women were invited to participate through the Federation of Deaf People of the Basque Country. Four discussion groups were developed between October 2013 and July 2014, with duration of 90-120 minutes. The discussion groups were recorded in video for their later literal transcription in which the service of interpreters of sign language of Euskadi participated. Thematic analyses carried out. RESULTS: Three main categories arise: 1) feelings of discrimination and limitation of the principle of autonomy; 2) barriers and facilitators in the accessibility to the health system; and 3) vulnerability of deaf women as a result of the lack of communication. CONCLUSIONS: Nowadays, deaf women continue having difficulties in accessing to the health system in our context. The results of this study can be the starting point for the development of health policies and institutional protocols

2.
Artigo em Inglês | MEDLINE | ID: mdl-33171297

RESUMO

PURPOSE: We have previously reported an association between high red blood cell distribution width (RDW) and mortality in septic and brain infarction patients. However, no association between RDW and mortality in coronavirus disease 2019 (COVID-19) patients has been reported so far; thus, the objective of this study was to determine if that association exists. METHODS: Prospective and observational study carried out in 8 Intensive Care Units from 6 hospitals of Canary Islands (Spain) including COVID-19 patients. We recorded RDW at ICU admission and 30-day survival. RESULTS: We found that patients who did not survive (n=25) compared to surviving patients (n=118) were older (p=0.004), showed higher RDW (p=0.001), urea (p<0.001), APACHE-II (p<0.001) and SOFA (p<0.001), and lower platelet count (p=0.007) and pH (p=0.008). Multiple binomial logistic regression analysis showed that RDW was associated with 30-day mortality after controlling for: SOFA and age (OR=1.659; 95% CI=1.130-2.434; p=0.01); APACHE-II and platelet count (OR=2.062; 95% CI=1.359-3.129; p=0.001); and pH and urea (OR=1.797; 95% CI=1.250-2.582; p=0.002). The area under the curve (AUC) of RDW for mortality prediction was of 71% (95% CI=63-78%; p<0.001). We did not find significant differences in the predictive capacity between RDW and SOFA (p=0.66) or between RDW and APACHE-II (p=0.12). CONCLUSIONS: Our study provides new information regarding the ability to predict mortality in patients with COVID-19. There is an association between high RDW and mortality. RDW has a good performance to predict 30-day mortality, similar to other severity scores (such as APACHE II and SOFA) but easier and faster to obtain.

4.
Int J Nurs Stud ; 113: 103740, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-33099179

RESUMO

OBJECTIVE: To examine the research evidence about whether families were allowed to witness cardiopulmonary resuscitation on hospitalised adult and paediatric patients; and the views of patients, families and health professionals, about witnessed cardiopulmonary resuscitation. DESIGN: An umbrella review methodology of systematic reviews with sufficient methodological quality. REVIEW METHODS: Papers published in Spanish and English between, 1 January 2009 and 31 December 2018 were considered. The following databases were searched: PubMed, CINAHL, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, PsycInfo, Embase, the Central Supplier Database and the Joanna Briggs Institute, Evidence-based Practice Database. Two independent reviewers assessed the papers for methodological quality employing instruments from the Joanna Briggs Institute. Critical appraisal, extraction and synthesis were carried out, employing the established methods for umbrella reviews and the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO number CRD42019145610). RESULTS: The search identified 12 systematic reviews with moderate-to-high quality, which covered 110 original papers. Habitually, health professionals expressed controversial views and showed some reluctance to let families be present during cardiopulmonary resuscitation. In contrast, family members felt strongly that they should be present and patients agreed. Key factors that facilitated witnessed cardiopulmonary were a formal institutional policy, educating health professionals, and designating a health professional to support the family. Educational and cultural backgrounds influenced healthcare professionals' experiences and their attitudes towards witnessed cardiopulmonary resuscitation. In general, Anglo-Saxon countries showed greater support for this practice. These included the United States, which was the country that dominated the literature on this subject. CONCLUSIONS: The best available evidence supports allowing the family to be present during cardiopulmonary resuscitation. It is necessary to include this practice in educational curricula and to train emergency personnel in its implementation. Culturally sensitive policies need to be designed, and the public to be aware of their right to be present.

5.
An. pediatr. (2003. Ed. impr.) ; 93(3): 152-160, sept. 2020. tab, graf
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET5-2091

RESUMO

OBJETIVOS: Evaluar la efectividad y la seguridad de la presión continua en la vía aérea (CPAP) en lactantes trasladados por insuficiencia respiratoria aguda (IRA) y comparar el curso clínico y la evolución en la unidad de cuidados intensivos pediátricos (UCIP) de los pacientes trasladados con dicha terapia vs la oxigenoterapia convencional. MATERIAL Y MÉTODOS: Estudio observacional y analítico de una cohorte retrospectiva. Se revisaron las historias de los lactantes de 0 a 12meses con IRA que precisaron traslado interhospitalario a la UCIP. RESULTADOS: Se incluyeron 110 pacientes: 71 trasladados con CPAP y 39 con oxigenoterapia. La causa principal de IRA fue la bronquiolitis (81,8%). La mediana del nivel de CPAP fue de 7cmH2O (rango intercuartílico, 6-7). Controlando en análisis multivariables específicos por los valores previos, se obtuvo que la CPAP durante el traslado produjo una disminución significativa en el score de Wood-Downes (beta=−1,08; IC95%: −1,76 a 0,40; p = 0,002) y en la frecuencia cardiaca (beta=−19,64, IC95%: −28,46 a −10,81; p < 0,001). Ningún paciente precisó intubación endotraqueal durante el transporte. En la UCIP, la tasa de intubación fue similar en el grupo CPAP (7%) y en el de oxigenoterapia (5,1%) (p = 0,689). El porcentaje de pacientes que precisaron ventilación no invasiva con dos niveles de presión en las primeras 6h de ingreso en la UCIP fue mayor en el grupo de oxigenoterapia: 100% (11/11) vs 69,2% (18/26), p = 0,04. CONCLUSIONES: La administración precoz de CPAP en lactantes es segura durante el traslado interhospitalario. Durante el transporte, la CPAP comparada con la oxigenoterapia disminuye el score de Wood-Downes y la frecuencia cardiaca


OBJECTIVE: The aims of our study are to evaluate the effectiveness and security of CPAP (continuous positive airway pressure) in infants transferred with acute respiratory failure (ARF) and to compare their evolution in PICU between CPAP vs oxygen therapy. MATERIALS AND METHODS: We conducted a retrospective observational and analytical study by reviewing the health records of infants with ARF aged 0 to 12months that required interhospital transfer to the PICU. RESULTS: We included 110 patients: 71 transported with CPAP and 39 with oxygen therapy. The main cause of ARF was acute bronchiolitis (81.8%). The median level of CPAP was 7cmH2O (interquartile range, 6-7). Controlling by the previous values in specific multivariable models, CPAP produced a significant decrease in the Wood-Downes score (beta = −1.08; 95% CI = −1.76 to −0.40; P = .002) and the heart rate (beta = −19.64, 95% CI = −28.46 to −10.81; P < .001). No patients required endotracheal intubation during transport. During the PICU stay, the intubation rate was similar in the CPAP group (7%) and the oxygen therapy group (5.1%) (P=.689). The proportion of patients that required bilevel positive airway pressure within 6hours of admission to the PICU was higher in the oxygen therapy group: 100% (11/11) vs 69.2% (18/26), P=.04. CONCLUSIONS: Early administration of CPAP to infants with ARF was a safe respiratory support intervention during interhospital transport. During patient transport, the use of CPAP achieved greater decreases in the Wood-Downes score and heart rate compared to oxygen therapy

6.
JCI Insight ; 5(21)2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-32990680

RESUMO

Patient-derived organoid models are proving to be a powerful platform for both basic and translational studies. Here we conduct a methodical analysis of pancreatic ductal adenocarcinoma (PDAC) tumor organoid drug response in paired patient-derived xenograft (PDX) and PDX-derived organoid (PXO) models grown under WNT-free culture conditions. We report a specific relationship between area under the curve value of organoid drug dose response and in vivo tumor growth, irrespective of the drug treatment. In addition, we analyzed the glycome of PDX and PXO models and demonstrate that PXOs recapitulate the in vivo glycan landscape. In addition, we identify a core set of 57 N-glycans detected in all 10 models that represent 50%-94% of the relative abundance of all N-glycans detected in each of the models. Last, we developed a secreted biomarker discovery pipeline using media supernatant of organoid cultures and identified potentially new extracellular vesicle (EV) protein markers. We validated our findings using plasma samples from patients with PDAC, benign gastrointestinal diseases, and chronic pancreatitis and discovered that 4 EV proteins are potential circulating biomarkers for PDAC. Thus, we demonstrate the utility of organoid cultures to not only model in vivo drug responses but also serve as a powerful platform for discovering clinically actionable serologic biomarkers.

7.
J Oral Sci ; 62(4): 415-419, 2020 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-32879157

RESUMO

This study sought to evaluate biofilm elimination using the HBW Ultrasonic Ring based on continuous ultrasonic irrigation. Forty-five premolars and molars with complex curvatures were included. An Enterococcus faecalis biofilm was established for 30 days on the extracted teeth. The teeth were then stratified into three experimental groups for instrumentation and irrigation (i.e. HBW Ultrasonic Ring, conventional irrigation, and passive ultrasonic irrigation). Pre- and post-instrumentation samples were collected, and reductions of bacterial load were evaluated by McFarland's scale, counting of colony-forming units, and scanning electronic microscopy. The HBW Ultrasonic Ring promoted a higher reduction in bacterial load relative to conventional irrigation (P < 0.05) and a similar reduction compared with passive ultrasonic irrigation (P > 0.05). These results suggest the HBW Ultrasonic Ring is a promising alternative modality for simultaneous instrumentation and irrigation during root canal treatment, achieving an appropriate level of bacterial reduction and allowing the passage of the irrigating solution throughout the entire working length.


Assuntos
Enterococcus faecalis , Irrigantes do Canal Radicular , Biofilmes , Cavidade Pulpar , Preparo de Canal Radicular , Hipoclorito de Sódio , Irrigação Terapêutica , Ultrassom
9.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32680796

RESUMO

INTRODUCTION: There are not data on blood B-cell lymphoma 2 (Bcl-2) concentrations (one of the antiapoptotic molecules of the Bcl-2 family in the intrinsic apoptosis pathway) in septic patients. Therefore, this study was carried with the aims to explore whether blood Bcl-2 concentrations at diagnosis of sepsis are different in survivor and non-survivor septic patients, are associated with mortality, and are useful for the mortality prediction. METHODS: Intensive Care Units from 3 Spanish hospitals participated in this observational and prospective study with septic patients and serum Bcl-2 concentrations at diagnosis of sepsis were determined. Mortality at 30 days was as outcome variable. RESULTS: We found that 30-day non-surviving patients (n=81) showed lower serum Bcl-2 levels (p=0.003) than surviving patients (n=140). We found that serum concentrations of Bcl-2<4.4ng/mL were associated with mortality (OR=3.228; 95% CI=1.406-7.415; p=0.006) in the multiple logistic regression analysis, and that showed an area under the curve for mortality prediction of 62% (95% CI=55-68%; p=0.003). CONCLUSIONS: In our study appears novel findings such as higher blood Bcl-2 concentrations in survivor than in non-survivor septic patients, the association between low blood Bcl-2 concentrations and mortality of septic patients, and the ability of blood Bcl-2 concentrations for the prediction of septic patient mortality.

10.
Sci Total Environ ; 742: 140505, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-32721718

RESUMO

The distribution of per- and polyfluoroalkyl substances (PFAS), alkylphenols, organotin compounds, phthalates, alkylated polycyclic aromatic hydrocarbons, current-use pesticides (CUPs) and personal care products (PCPs) was characterized in 29 surface sediments from two Spanish Iberian continental shelf areas (14 on the Atlantic and 15 on the Mediterranean coasts). Concretely, 115 organic contaminants were determined and a specific methodology was used for each contaminant group, including contaminants of emerging concern (CECs) and traditional ones, such as polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and organochlorinated pesticides (OCPs). PAHs, alkylated PAHs, alkylphenols and phthalates were found in all samples, showing mean concentrations per group higher than 20 ng/g (16-4974 ng/g d.w.) in the subregions under consideration (Galician, Cantabrian, Levantine-Balearic and Strait-Alboran). CUPs and PCPs were found in the majority of samples at very low concentrations of ng/g (1.4-46.8 ng/g d.w.), whereas organotins and PFAS were found principally in sediments from the Mediterranean subregions (2.5-3.9 ng/g d.w.). Different distribution patterns were observed for the contaminant groups and subregions under consideration as a consequence of the diverse predominant sources (industrial, urban, transport and agricultural activities) and environmental behavior (mainly hydrophobicity and persistence). Risk assessment confirmed the impact of phthalates, alkylphenols, PAHs and PCBs on Atlantic ecosystems and of alkylphenols, chlorpyrifos, phthalates, TBT, PAHs, OCPs and PCBs on the Mediterranean ones. Furthermore, the presence of CUPs, PCPs and PFAS in sediments from the Spanish continental shelf located between 2 and 31 km from the coast suggested that those contaminants may also provoke adverse effects on coastal marine ecosystems between their sources and their depositional areas. CAPSULE: Alkylphenols, phthalates and organotins may provoke adverse effects on Spanish coastal marine ecosystems from their sources to the sediment depositional areas.

11.
Acta Trop ; 212: 105643, 2020 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-32692976

RESUMO

Canine visceral leishmaniasis (CVL) is the major source of human visceral leishmaniasis. To control the spread of this disease, early and accurate detection of infected dogs is critical but challenging. The serological diagnosis of CVL remains problematic because there are no reliable commercially available tests. Most laboratories use enzyme-linked immunosorbent assay or the indirect immunofluorescent antibody test. These tests use Leishmania chagasi recombinant antigens K39 or K26 assembled with either gold-labelled Staphylococcus aureus protein A or protein G from Streptococcus pyogenes. In this work, we propose the development, optimization and standardization of a lateral flow immunoassay (LFIA) based on functionalized colored particles and a specific recombinant antigen, as a visual in situ method for the diagnosis of CVL. The following analysis variables were considered: (i) the concentration of the latex-protein complex; (ii) the dilution of the serum; (iii) the composition of the employed buffers; (iv) the nominal capillary flow time through the nitrocellulose membrane; (v) the concentration of reagents fixed in the test and control lines; (vi) the particle size of the colored latex; and (vii) the conjugation method. Then, the obtained strips were evaluated as a visual diagnostic tool based on a panel of positive and negative sera. It was observed that because of its simplicity and performance the LFIA test is a quick and reliable alternative for the diagnosis of CVL either in conventional laboratories or for remote areas where laboratories are not readily accessible for conventional assays.

13.
Cells ; 9(7)2020 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-32630670

RESUMO

Angiopoietin-1 (Ang-1) is a ligand of Tie-2 receptors that promotes angiogenesis. It has been established that regulatory loops exist between angiogenic growth factors and distinct pro or anti-angiogenic miRNAs, but the nature and the roles of Ang-1-regulated miRNAs remain unclear. In this study, we assessed the role of miR-640 in Ang-1-induced angiogenesis in human umbilical vein endothelial cells (HUVECs). Exposure to Ang-1 (300 ng/mL) from 6 to 72 h significantly decreased expression of mature miR-640, a response that was mediated by Tie-2 receptors and was also observed in response to Ang-2, the vascular endothelial growth factor, and transforming growth factor ß. Increasing miR-640 levels using a mimic inhibited Ang-1-induced cell migration and capillary-like tube formation whereas inhibition of miR-640 enhanced these responses. Pull down assays of biotinylated miR-640 revealed that miR-640 directly targets Zinc Finger Protein 91 (ZFP91), an atypical E3-ubiquitin ligase. Ang-1 exposure induced ZFP91 expression through down-regulation of miR-640. Silencing of ZFP91 significantly inhibited Ang-1-induced cell migration and tube formation. We conclude that Ang-1 upregulates ZFP91 expression through transcriptional down-regulation of miR-640 and that ZFP91 plays important roles in the promotion of Ang-1-induced endothelial cell migration and differentiation.

14.
Genesis ; 58(7): e23369, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32543746

RESUMO

Extracellular vesicles (EVs) are abundant, lipid-enclosed vectors that contain nucleic acids and proteins, they can be secreted from donor cells and freely circulate, and they can be engulfed by recipient cells thus enabling systemic communication between heterotypic cell types. However, genetic tools for labeling, isolating, and auditing cell type-specific EVs in vivo, without prior in vitro manipulation, are lacking. We have used CRISPR-Cas9-mediated genome editing to generate mice bearing a CD63-emGFPloxP/stop/loxP knock-in cassette that enables the specific labeling of circulating CD63+ vesicles from any cell type when crossed with lineage-specific Cre recombinase driver mice. As proof-of-principle, we have crossed these mice with Cdh5-CreERT2 mice to generate CD63emGFP+ vasculature. Using these mice, we show that developing vasculature is marked with emerald GFP (emGFP) following tamoxifen administration to pregnant females. In adult mice, quiescent vasculature and angiogenic vasculature (in tumors) is also marked with emGFP. Moreover, whole plasma-purified EVs contain a subpopulation of emGFP+ vesicles that are derived from the endothelium, co-express additional EV (e.g., CD9 and CD81) and endothelial cell (e.g., CD105) markers, and they harbor specific miRNAs (e.g., miR-126, miR-30c, and miR-125b). This new mouse strain should be a useful genetic tool for generating cell type-specific, CD63+ EVs that freely circulate in serum and can subsequently be isolated and characterized using standard methodologies.

15.
Fam Syst Health ; 38(2): 105-115, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32525347

RESUMO

INTRODUCTION: Chronic conditions, particularly diabetes, and related health conditions continue to be a major concern in the United States, especially in Hispanic populations. This study evaluated the effect of an integrated behavioral health care model, including promotoras(es), on a primarily Hispanic population living with diabetes. METHOD: Seven hundred fifty-six participants were enrolled in an intervention (n = 329) or comparison group (n = 427) and followed up for 12 months. We used a quasiexperimental design to compare participants who received coordinated integrated behavioral health care with those who received usual care from a federally qualified health center. The outcomes were HbA1c, blood pressure, body mass index, depressive symptoms (Patient Health Questionnaire-9), and quality of life (QoL). These outcomes were analyzed as continuous variables using linear regression with backward model selection. Longitudinal analyses were conducted using a likelihood-based approach to general linear mixed models. RESULTS: A total 563 intervention (n = 239) and comparison (n = 324) participants completed an end point assessment. After adjusting for important covariates, the intervention had a QoL score 5.36 points higher than the comparison participants on average after 12 months. The trajectories of QoL and Patient Health Questionnaire-9 scores differed over time, with intervention participants experiencing greater improvements. There were no statistically significant differences detected for other outcomes. DISCUSSION: Enabling access to services and providers to enhance participants' ability to manage their chronic disease led to positive impacts on mental health. The connection between QoL and diabetes has been of great interest to researchers, including the effects of relationships with promotoras(es). The impact of integrating care on QoL in this vulnerable population is discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

16.
An Pediatr (Barc) ; 93(3): 152-160, 2020 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-32044198

RESUMO

OBJECTIVE: The aims of our study are to evaluate the effectiveness and security of CPAP (continuous positive airway pressure) in infants transferred with acute respiratory failure (ARF) and to compare their evolution in PICU between CPAP vs oxygen therapy. MATERIALS AND METHODS: We conducted a retrospective observational and analytical study by reviewing the health records of infants with ARF aged 0 to 12months that required interhospital transfer to the PICU. RESULTS: We included 110 patients: 71 transported with CPAP and 39 with oxygen therapy. The main cause of ARF was acute bronchiolitis (81.8%). The median level of CPAP was 7cmH2O (interquartile range, 6-7). Controlling by the previous values in specific multivariable models, CPAP produced a significant decrease in the Wood-Downes score (beta = -1.08; 95% CI = -1.76 to -0.40; P = .002) and the heart rate (beta = -19.64, 95% CI = -28.46 to -10.81; P < .001). No patients required endotracheal intubation during transport. During the PICU stay, the intubation rate was similar in the CPAP group (7%) and the oxygen therapy group (5.1%) (P=.689). The proportion of patients that required bilevel positive airway pressure within 6hours of admission to the PICU was higher in the oxygen therapy group: 100% (11/11) vs 69.2% (18/26), P=.04. CONCLUSIONS: Early administration of CPAP to infants with ARF was a safe respiratory support intervention during interhospital transport. During patient transport, the use of CPAP achieved greater decreases in the Wood-Downes score and heart rate compared to oxygen therapy.

18.
J Infect Public Health ; 13(4): 509-513, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31813835

RESUMO

BACKGROUND: Human immunodeficiency virus (HIV) incidence should be calculated in cross-sectional studies using recent infection testing algorithms (RITA) that consider clinical variables and serological test results such as enzyme-linked immunosorbent assay (ELISA) and dried blood spot (DBS) analysis. METHODS: The correlation between serum samples and DBS was evaluated using two commercial ELISA kits: SediaTM BED HIV-1 Incidence EIA (BED-Sedia) and Maxim HIV-1 Limiting Antigen Avidity (LAg-Avidity). Eight different RITAs were developed; all of them included serological assays. A combination of the variables viral load, antiretroviral therapy (ART) and CD4 count was used to build the RITAs. The sensitivity, specificity, Youden index, predictive positive value, predictive negative value, false recent rate (FRR) and false long-term rate were evaluated. RESULTS: The correlations between serum samples and DBS were 0.990 and 0.867 for BED-Sedia and LAg-avidity, respectively. Using only serological assays, the Youden index was higher for LAg-avidity than BED-Sedia (82.1-83.0% versus 69.2-69.6%). The best RITA was ART-serology, which showed a Youden index of 91.2-93.9% and FRR of 1.8-2.2%. CONCLUSIONS: Using DBS samples to determine HIV incidence is a good tool for epidemiological surveillance. The RITA that included ART and serological tests (BED-Sedia or LAg-avidity) showed the highest sensitivity and specificity and a low FRR.


Assuntos
Sorodiagnóstico da AIDS , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Sorodiagnóstico da AIDS/métodos , Sorodiagnóstico da AIDS/estatística & dados numéricos , Algoritmos , Contagem de Linfócito CD4 , Teste em Amostras de Sangue Seco , Ensaio de Imunoadsorção Enzimática , Infecções por HIV/virologia , Humanos , Incidência , Masculino , México/epidemiologia , Carga Viral
20.
Nurs Ethics ; 27(2): 333-347, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31113269

RESUMO

BACKGROUND: The decision whether to initiate cardiopulmonary resuscitation may sometimes be ethically complex. While studies have addressed some of these issues, along with the role of nurses in cardiopulmonary resuscitation, most have not considered the importance of nurses acting as advocates for their patients with respect to cardiopulmonary resuscitation. RESEARCH OBJECTIVE: To explore what the nurse's advocacy role is in cardiopulmonary resuscitation from the perspective of patients, relatives, and health professionals in the Basque Country (Spain). RESEARCH DESIGN: An exploratory critical qualitative study was conducted from October 2015 to March 2016. Thematic analysis was used to analyse the data. PARTICIPANTS: Four discussion groups were held: one with patients and relatives (n = 8), two with nurses (n = 7 and n = 6, respectively), and one with physicians (n = 5). ETHICAL CONSIDERATIONS: Approval was obtained from the Basque Country Clinical Research Ethics Committee. FINDINGS: Three significant themes were identified: (a) accompanying patients during end of life in a context of medical dominance, (b) maintaining the pact of silence, and (c) yielding to legal uncertainty and concerns. DISCUSSION: The values and beliefs of the actors involved, as well as pre-established social and institutional rules reduced nurses' advocacy to that of intermediaries between the physician and the family within the hospital environment. On the contrary, in primary health care, nurses participated more actively within the interdisciplinary team. CONCLUSION: This study provides key information for the improvement and empowerment for ethical nursing practice in a cardiac arrest, and provides the perspective of patients and relatives, nurses and physicians.

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