RESUMEN
The present study investigates the effects of hypothyroidism on both the redox state and the thyroid hormone receptors expression in the heart ventricle of virgin and pregnant rats.Hypothyroid state was induced by 6-n-propyl-2-thiouracil in drinking water given to Wistar rats starting 8 days before mating until day 21 of pregnancy or for 30 days in virgin rats. Serum paraoxonase-1 (PON-1) activity, serum and heart nitrites, and thiobarbituric acid-reactive substances (TBARS) were analyzed. Heart protein oxidation, as carbonyls, and copper-zinc superoxide dismutase (CuZnSOD), glutathione peroxidase (GPx), and catalase (CAT) activities, were determined. In addition, heart expressions of NADPH oxidase (NOX-2), CAT, SOD, GPx, and thyroid receptors (TRα and TRß) mRNA were assessed by RT-PCR. Inducible and endothelial Nitric Oxide Synthase (iNOS and eNOS) were determined by Western blot. Hypothyroidism in the heart of virgin rats decreased TRα and TRß expressions, and induced oxidative stress, leading to a decrease of nitrites and an increase of carbonyls, NOX-2 mRNA, and GPx activity. A decreased PON-1 activity suggested low protection against oxidative stress in blood circulation. Pregnancy reduced TRα and TRß mRNA expressions and induced oxidative stress by increasing nitrite and TBARS levels, SOD and CAT activities and NOX-2, eNOS and iNOS expressions, while hypothyroidism, emphasized the decreases of TRα mRNA levels and did not alter the redox state in the heart. TR expressions and redox balance of rat hearts depend on the physiological state. Pregnancy per se seems to protect the heart against oxidative stress induced by hypothyroidism. Supporting Information for this article is available online at http://www.thieme-connect.de/ejournals/toc/hmr.
Asunto(s)
Hipotiroidismo/patología , Miocardio/metabolismo , Miocardio/patología , Estrés Oxidativo , Animales , Antioxidantes/metabolismo , Western Blotting , Femenino , Regulación de la Expresión Génica , Hipotiroidismo/sangre , Hipotiroidismo/enzimología , Hipotiroidismo/genética , Miocardio/enzimología , Óxido Nítrico Sintasa de Tipo II/metabolismo , Óxido Nítrico Sintasa de Tipo III/metabolismo , Oxidación-Reducción , Embarazo , ARN Mensajero/genética , ARN Mensajero/metabolismo , Ratas , Ratas Wistar , Receptores de Hormona Tiroidea/genética , Receptores de Hormona Tiroidea/metabolismoRESUMEN
Intrarenal concentration of angiotensin II increases after the onset of ureteral obstruction in the obstructed kidney. The effect of pretreatment with losartan, a specific angiotensin II AT1 receptor antagonist, on lipid contents, which were previously modified by unilateral ureteral obstruction (UUO), was studied in renal cortex of rats. Adult Wistar Kyoto rats were subjected to either UUO for 24 hr or control sham operation after being treated with losartan in the drinking water at 10 mg/kg rat/day for 15 days. In the cortex of obstructed kidney the increased free and esterified cholesterol concentrations were associated with the increased cholesterol synthesis measured by incorporation of 14C-acetate (0.001>p), compared with control and contralateral kidneys. The increased amount of phosphatidylcholine was related with the increased incorporation of 14C-choline into phosphatidylcholine (0.01>p). Phosphatidylethanolamine and sphingomyelin decreased slightly but total phospholipid content did not change. The level of AT1 receptor mRNA in obstructed kidney was significantly lower than in control and contralateral kidneys. Losartan pretreatment attenuated (0.01>p) the increase in cholesterol content and synthesis and restored and enhanced the AT1 angiotensin II receptor gene expression. The interference in the renin-angiotensin system before UUO may modify renal cortex cholesterol content.
Asunto(s)
Bloqueadores del Receptor Tipo 1 de Angiotensina II/farmacología , Corteza Renal/metabolismo , Metabolismo de los Lípidos/efectos de los fármacos , Lípidos/análisis , Losartán/farmacología , Obstrucción Ureteral/metabolismo , Angiotensina II/metabolismo , Animales , Colesterol/metabolismo , Ácidos Grasos/metabolismo , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Regulación de la Expresión Génica/fisiología , Corteza Renal/efectos de los fármacos , Corteza Renal/fisiopatología , Fosfatidilcolinas/metabolismo , Fosfatidiletanolaminas/metabolismo , ARN Mensajero/análisis , Ratas , Ratas Endogámicas WKY , Receptor de Angiotensina Tipo 1/análisis , Receptor de Angiotensina Tipo 1/genética , Sistema Renina-Angiotensina/efectos de los fármacos , Sistema Renina-Angiotensina/fisiología , Esfingomielinas/metabolismoRESUMEN
ANTECEDENTES El embarazo ectópico abdominal es el menos habitual de los embarazos ectópicos, con una prevalencia situada entre el 0.9 - 1.4%. La mortalidad materna es elevada, alcanzando un 20% y la viabilidad fetal mínima. El manejo médico en estas situaciones es complicado ya que no está bien establecido debido a su baja frecuencia. CASO CLÍNICO Mujer de 35 años, con antecedente de esterilidad por endometriosis y salpinguectomía bilateral. Tras 5 fecundaciones in vitro (FIV) consigue una primera gestación, con finalización mediante cesárea por no progresión de parto. Acude a urgencias en su segundo embarazo, logrado tras 3 (FIV), con edad gestacional de 7 semanas. Presenta sangrado vaginal escaso y la ecografía demuestra a nivel de Douglas y hacia fosa iliaca izquierda un saco gestacional de 3 cm con embrión sin latido cardiaco de 5 mm. El nivel de β-hcg es de 1477 mUI/ml. Se diagnostica de gestación ectópica abdominal y se opta por actitud expectante dada la estabilidad clínica de la paciente. En un control a las 48h la β-Hcg es de 464 mUI/ml y la paciente se mantiene estable. En controles posteriores se observan niveles descendentes de β-Hcg y tras un mes la resolución es completa. CONCLUSIÓN El embarazo ectópico abdominal es una entidad poco frecuente pero con una alta tasa de mortalidad. Aunque lo más común es optar por un abordaje quirúrgico es necesario individualizar cada caso y basarse en la clínica y las diferentes pruebas diagnósticas para seleccionar aquellos casos que se pueden beneficiar de un manejo conservador.
BACKGROUND Abdominal ectopic pregnancy accounts for only 0.9-1.4% of all ectopic pregnancies. The maternal mortality rate is high (up to 20%) and fetal viability mínimum. The managment, specially the conservatory management of these cases is difficult because of our limited experiencie due to its low frecuency. CASE PRESENTATION 35-year-old woman, with history of sterility due to endometriosis that required bilateral laparoscopic salpinguectomy. Her first pregnancy (after 5 in vitro fertilization cicles (IVF)) finalized with a caesarean section because of to the lack of labour progresion. She was admitted to our emergency department during her second pregnancy (after 3 IVF cicles), with 7 weeks of gestational age. She had a little vaginal bleeding. Ultrasound scan showed a 5mm gestational sac with a 3mm embryo without cardiac activity in the pouch of Douglas. The β-Hcg level was 1477mUI/ml. The final diagnosis was ectopic abdominal pregnancy and it was decided to undertake an expectant management because she was clinically stable. The β-Hcg level after 48 hours was 464 mUI/ml. In subsequent examinations β-Hcg showed descending levels and after one month the resolution was completed. CONCLUSION Abdominal ectopic pregnancy is very infrequent but it has a high mortality rate. The most common approach is surgical but it is necessary to study all signs and diagnostic tests to select patients that could get profit from a conservatory management.
Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Embarazo Abdominal/diagnóstico , Fertilización In Vitro/efectos adversos , Salpingectomía/efectos adversos , Infertilidad Femenina/etiología , Embarazo Abdominal/sangre , Embarazo Ectópico , Ultrasonografía Prenatal , Gonadotropina Coriónica Humana de Subunidad beta/sangre , Espera Vigilante , Tratamiento ConservadorRESUMEN
INTRODUCCIÓN: El mesotelioma peritoneal multiquístico benigno (MPMB) es una entidad con muy baja incidencia que se presentan con mayor frecuencia en mujeres jóvenes. CASO CLÍNICO: Paciente de 17 años que consulta por amenorrea secundaria. Además, refería pérdida de peso, estreñimiento y molestias abdominales. La exploración fue normal y en las pruebas de imagen se objetivó una pelvis ocupada por una masa multiquística, de unos 20 cm de diámetro máximo, de paredes finas y contenido anecoico. Se solicitaron marcadores tumorales de los cuales sólo se encontró elevado el CA 19.9 (35,2 U/mL). Se decidió realizar una laparoscopia exploradora para establecer un diagnóstico y ante los hallazgos y al considerarse la masa fácilmente resecable, en el mismo acto quirúrgico se extirpó por completo para su estudio anatomopatológico, que confirmó un MPMB. Se desestimaron tratamientos adicionales y actualmente se encuentra en seguimiento y asintomática. CONCLUSIÓN: La patogénesis del MPMB no está clara. Algunos autores defienden que se trata de una reacción peritoneal a un daño inflamatorio, otros apoyan que se trata de una neoplasia benigna. Esta naturaleza incierta, junto con la escasa experiencia, hacen que el manejo resulte complejo. Es necesario individualizar cada caso e intentar ser conservadores especialmente en pacientes jóvenes. Si se opta por un manejo activo, lo más acertado es la citorreducción completa seguida de quimioterapia hipertérmica peritoneal. El seguimiento, en cualquier caso, debe ser exhaustivo y multidisciplinar principalmente con pruebas de imagen.
BACKGROUND: Benign Multicystic Peritoneal Mesothelioma (BMPM) is an entity with a very low incidence that occurs more frequently in young women. CASE REPORT: A 17-year-old woman attended for secondary amenorrhea. She also referred to weight loss, constipation and abdominal discomfort. The examination was normal and echography revealed a pelvis occupied by a 20 centimeters multicystic mass, with thin walls and anechoic content. A preoperative study with tumor markers was requested in which only a CA 19.9 elevation was observed (35.2 U/ml 0-27). It was decided to perform an exploratory laparoscopy to establish a diagnosis. Due to the findings and because of the fact that the mass was considered easy to remove, it was completely removed in the same surgical act. The pathological result confirmed a BMPM. Additional treatments have been dismissed and are the patient is currently being followed up without symptoms. CONCLUSION: The pathogenesis of BMPM is unclear. Some authors argue that it is a peritoneal reaction to inflammatory damage, others support that it is a benign neoplasm. This uncertain nature coupled with limited experience make management complex. It is necessary to evaluate each case and try to be conservative especially in young patients. If surgery management is chosen, complete cytoreduction followed by hyperthermic peritoneal chemotherapy is the most successful option. The follow-up in any case must be exhaustive and multidisciplinary, mainly with imaging tests.
Asunto(s)
Humanos , Femenino , Adolescente , Neoplasias Peritoneales/cirugía , Neoplasias Peritoneales/diagnóstico , Mesotelioma Quístico/cirugía , Mesotelioma Quístico/diagnóstico , Imagen por Resonancia Magnética , Ultrasonografía , LaparoscopíaRESUMEN
Two cellulose derivatives bearing simultaneously 10-undecenoyl and 3,5-dimethylphenylaminocarbonyl groups in different ratios were chemically bonded on allylsilica gels of different porosity. The systematic study of the effect of the silica gel pore size on the bonding of the polysaccharide derivative and on the performance of the resulting chiral supports is presented.
Asunto(s)
Celulosa , Cromatografía Líquida de Alta Presión/métodos , Dióxido de Silicio , Cloroformo , Cromatografía Líquida de Alta Presión/estadística & datos numéricos , Heptanos , Sensibilidad y Especificidad , Gel de Sílice , Dióxido de Silicio/química , EstereoisomerismoRESUMEN
Polysaccharide derivatives have been extensively used as chromatographic chiral selectors in chiral stationary phases (CSPs) for the separation of enantiomers by HPLC. When coated onto a silica matrix, they represent nowadays one of the most popular type of CSPs. However, they are only compatible with a limited choice of solvents. The main drawback of these CSPs is related to the solubility of the chiral selector in a number of solvents, which limits their applicability. The different attempts which have been described up to now to overcome this problem by covalently fixing the chiral selector to a matrix are reviewed in this paper.
Asunto(s)
Cromatografía Líquida de Alta Presión/instrumentación , Polisacáridos/químicaRESUMEN
Four mixed 10-undecenoyl-3,5-dimethylphenylaminocarbonyl derivatives of cellulose, with an increasing proportion of alkenoyl groups, were synthesized and chemically bonded on allylsilica gel. The influence of the degree of fixation of the cellulose derivative on the matrix for the four resulting chiral stationary phases on their selectivity is discussed.
Asunto(s)
Celulosa/química , Cromatografía Líquida de Alta Presión/métodos , Fenómenos Químicos , Química Física , Lorazepam/química , Lorazepam/aislamiento & purificación , Espectroscopía de Resonancia Magnética , Estructura Molecular , Propranolol/química , Propranolol/aislamiento & purificación , Estructura Secundaria de Proteína , Solubilidad , EstereoisomerismoRESUMEN
Bonded polysaccharide-derived chiral stationary phases were found to be useful for the preparation of the four stereoisomers of the cyclopropane analogue of phenylalanine (c(3)Phe) as well as for the direct determination of the enantiomeric purity of c(3)Phe derivatives by HPLC. Three chiral stationary phases, consisting of cellulose and amylose derivatives chemically bonded on allylsilica gel, were tested. The mixed 10-undecenoate/3, 5-dimethylphenylcarbamate of cellulose, 10-undecenoate/3, 5-dimethylphenylcarbamate of amylose and 10-undecenoate/p-methylbenzoate of cellulose were the starting polysaccharide derivatives for CSP-1, CSP-2, and CSP-3, respectively. Using mixtures of n-hexane/chloroform/2-propanol as mobile phase on a semi-preparative column (150 mm x 20 mm ID) containing CSP-2, we separated about 1.7 g of racemic cis-methyl 1-tert-butoxycarbonylamino-2-phenylcyclopropanecarboxylate (cis-6) and 1.2 g of racemic trans-methyl-1-tert-butoxycarbonylamino-2-phenylcycloprop-anecarboxyl ate (trans-6) by successive injections. Copyright 1999 Wiley-Liss, Inc.
RESUMEN
The preparation of mixed 10-undecenoyl/phenylaminocarbonyl or benzoyl derivatives of chitosan is described. Several mixed derivatives were prepared using differently substituted aryl isocyanates or benzoyl chlorides. The reactivity of the starting polysaccharide was found to be influenced by the acetyl content.
Asunto(s)
Quitina/síntesis química , Alcanos/química , Amidas/química , Compuestos de Anilina/química , Quitina/análogos & derivados , Quitina/química , Quitosano , Cromatografía de Afinidad/métodos , Cromatografía Líquida de Alta Presión/métodos , Indicadores y Reactivos/síntesis química , Espectroscopía de Resonancia MagnéticaRESUMEN
Derivatives of cellulose, amylose and chitosan, bearing simultaneously 10-undecenoyl and arylaminocarbonyl or benzoyl groups were characterized by the combined use of 1H NMR and elemental analysis. The mathematical manipulation of elemental analysis data permits the calculation of the degree of substitution for each kind of substituent. The method was validated and is applicable to other derivatives.
Asunto(s)
Polisacáridos/química , Algoritmos , Amilosa/análogos & derivados , Amilosa/química , Carbono/análisis , Celulosa/análogos & derivados , Celulosa/química , Quitina/análogos & derivados , Quitina/química , Quitosano , Cloro/análisis , Hidrógeno/análisis , Espectroscopía de Resonancia Magnética , Nitrógeno/análisisRESUMEN
Male goats ("Criolla Argentina" breed), castrated at 45 days of age, showed altered lipid metabolism 180 days after castration as compared to control goats. Subcutaneous, perirenal and omental adipose tissues of castrated goats showed increases in fatty acid synthetase, glucose-6-phosphate dehydrogenase and NADP-isocitrate dehydrogenase activities. Castration increased the amount of total lipids and triglycerides, but did not modify the amount of cholesterol, phospholipid and protein in the three types of adipose tissue. The incorporation of [1-14C]acetate into fatty acids of subcutaneous and perirenal adipose tissue was increased in castrated goats in relation to noncastrated goats. Our results suggest that removal of gonadal steroids increases significantly the rate of lipogenesis in adipose tissue of male goats.
Asunto(s)
Tejido Adiposo/metabolismo , Metabolismo de los Lípidos , Testículo/fisiología , Animales , Ácido Graso Sintasas/metabolismo , Glucosafosfato Deshidrogenasa/metabolismo , Cabras , Isocitrato Deshidrogenasa/metabolismo , Masculino , OrquiectomíaRESUMEN
The resolution of four racemic 3-hydroxy-1,4-benzodiazepin-2-ones, widely used in therapeutics, by means of a chiral stationary phase is described. The chiral selector used is (S)-N-(3,5-dinitrobenzoyl)phenylalanine. This chiral stationary phase showed both good enantioselectivity and efficiency for the compounds. Elution times were in all cases shorter than those previously reported for such compounds on different stationary phases. Racemic oxazepam was used to evaluate the loading capacity of the chiral stationary phase.
Asunto(s)
Ansiolíticos/aislamiento & purificación , Benzodiazepinas , Cromatografía Líquida de Alta Presión , Ansiolíticos/análisis , Ansiolíticos/química , Lorazepam/análogos & derivados , Lorazepam/análisis , Lorazepam/química , Lorazepam/aislamiento & purificación , Oxazepam/análisis , Oxazepam/química , Oxazepam/aislamiento & purificación , Dióxido de Silicio/química , Estereoisomerismo , Temazepam/análisis , Temazepam/química , Temazepam/aislamiento & purificaciónRESUMEN
We investigated the effects of a saturated fat diet on lipid metabolism and arachidonic acid (AA) turnover in mouse resident peritoneal macrophages. The pro-oxidative effect of this diet was also studied. Female C57BL/6 mice were weaned at 21 days of age and assigned to either the experimental diet containing coconut oil (COCO diet), or the control diet containing soybean oil as fat source (10 mice per group). The fat content of each diet was 15% (w/w). Mice were fed for 6 weeks and then sacrificed. The concentration of total lipids, triglycerides, (LDL+VLDL)-cholesterol, thiobarbituric acid-reactive substances (TBARS) and reduced glutathione were increased in the plasma of mice fed the COCO diet, without changes in phospholipid or total cholesterol concentrations compared to control. The concentrations of total cholesterol, free and esterified cholesterol, triglycerides, and TBARS were increased in the macrophages of COCO-fed mice, while the content of total phospholipids did not change. The phospholipid composition showed an increase of phosphatidylcholine and a decrease of phosphatidylethanolamine. The [3H]-AA distribution in the phospholipid classes showed an increase in phosphatidylcholine and phosphatidylethanolamine. Incorporation of [3H]-cholesterol into the macrophages of COCO-fed mice and into the cholesterol ester fraction was increased. The COCO diet did not affect [3H]-AA uptake but induced an increase in [3H]-AA release. The COCO diet also enhanced AA mobilization induced by lipopolysaccharide. These results indicate that the COCO diet, high in saturated fatty acids, alters the lipid metabolism and AA turnover of peritoneal macrophages in female mice and also produces a significant degree of oxidative stress.
Asunto(s)
Ácido Araquidónico/metabolismo , Grasas de la Dieta/farmacología , Metabolismo de los Lípidos , Macrófagos Peritoneales/efectos de los fármacos , Estrés Oxidativo/efectos de los fármacos , Aceites de Plantas/farmacología , Animales , Peso Corporal , Colesterol/metabolismo , Aceite de Coco , Femenino , Peroxidación de Lípido/efectos de los fármacos , Macrófagos Peritoneales/metabolismo , Ratones , Ratones Endogámicos C57BL , Sustancias Reactivas al Ácido Tiobarbitúrico/análisis , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismoRESUMEN
This study was carried out to determine a possible relationship between hepatic acetyl-coenzyme A carboxylase EC 6.4.1.2 (ACC) activity in dam and fetus at 15-day and 19-day of gestation and the glucose tolerance in pregnant rats fed on the sucrose diet compared with the rats feed on the dextrin diet. Sucrose feeding increases ACC activity in livers of dam and fetus and the level of circulating LDL + VLDL cholesterol in the dam. Those findings are correlated with the high serum glucose and insulin concentrations observed in the sucrose-fed rats following oral glucose challenge in both 15-day and 19-day pregnant rats compared with the dextrin-fed rats. These results suggest that sucrose feeding to pregnant rats modified the hepatic lipid metabolism in them and in their fetus, associated with the changes in serum glucose and insulin levels.
Asunto(s)
Sacarosa en la Dieta/farmacología , Feto/metabolismo , Glucosa/metabolismo , Metabolismo de los Lípidos , Hígado/metabolismo , Preñez/metabolismo , Acetil-CoA Carboxilasa/análisis , Acetil-CoA Carboxilasa/biosíntesis , Animales , Glucemia/análisis , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , VLDL-Colesterol/sangre , Dextrinas/administración & dosificación , Dextrinas/metabolismo , Inducción Enzimática/efectos de los fármacos , Femenino , Edad Gestacional , Prueba de Tolerancia a la Glucosa , Insulina/sangre , Hígado/embriología , Intercambio Materno-Fetal , Embarazo , Ratas , Ratas Wistar , Triglicéridos/sangreRESUMEN
There are evidences for modulation of immune function by the sympathetic nervous system and its principal neurotransmitter norepinephrine (NE) through superior ovarian nerve (SON)-coeliac ganglion-noradrenergic postganglionic innervation of the spleen. Seven days after SON transection at 53 days of age, the rat splenocytes were isolated and then cultured for 48 h. These culture media, used to stimulate ovaries from 60-day-old intact rats (neither SON-transected nor sham-operated) at diestrus 2 stage, in in vitro incubations, showed a decrease in progesterone release, an increase in estradiol release and no change in androstenedione release in relation to splenocyte culture media from control (sham-operated) rats. When splenocytes from SON transected (SON-t) rats were treated with vasoactive intestinal peptide (VIP) or neuropeptide Y (NPY), both at 10(-6) M for 24 h, their secretions increased the progesterone release while decreasing the estradiol release from the intact ovaries, compared with the secretions of untreated splenocytes from SON-t rats. Although the secretions of splenocytes treated with VIP decrease the androstenedione release from the ovaries, the treatment with NPY produced no change in hormone release. In the present paper the ovarian steroidogenic response, which was modified by the effects of an in vivo SON transection on spleen cells, was reverted by an in vitro system in which the splenocytes were treated with VIP or NPY. This could indicate that the spleen of SON-t rats does not receive those neuropeptides by neural route however, when they are added to splenocyte culture in vitro, the cell secretions revert the profile of steroid hormones released from the intact ovary. We also present functional evidence for modulation of the immune function by sympathetic nervous system and neurotransmitters other than NE.
Asunto(s)
Neuropéptido Y/farmacología , Ovario/metabolismo , Bazo/citología , Péptido Intestinal Vasoactivo/farmacología , Animales , Femenino , Ovario/inervación , Ratas , Ratas Sprague-Dawley , Esteroides/metabolismo , Sistema Nervioso Simpático/lesionesRESUMEN
Evidences presented indicating that factors produced by the pars tuberalis (PT) affect the prolactin liberation by the pars distalis (PD). The effect of the secretion products of bovine PT cells in culture medium was checked on dispersed PD cells of rats. PD cells were assayed in incubations of 30 minutes and superfusion experiments. When medium was obtained from total PT cells, the addition of 9 micrograms of protein was needed to reach the major stimulation of prolactin liberation. However, when the medium from 50-60% Percoll gradient fractions was used, only 4 micrograms of total protein were required. The partial purification of such medium by Sephadex G50 produced the same effect on the liberation of prolactin by PD cells with 80 ng of total protein. The active factor/s should have a molecular weight higher than 30 kDal. The results obtained suggest, at least for the prolactotrophic cells, that PD could be the effector organ for some of the secretory product(s) of PT.
Asunto(s)
Adenohipófisis/metabolismo , Prolactina/metabolismo , Animales , Masculino , Adenohipófisis/citología , Ratas , Ratas Sprague-DawleyRESUMEN
Debido al incremento de la nefrectomía laparoscópica para trasplante renal de donantes vivos en nuestro hospital en los últimos años (en 2017, 332 trasplantes renales de donante vivo, de los que 47 se hicieron en Andalucía y 17 de ellos en nuestro centro), se ha realizado un estudio prospectivo en el cual se analizaron, con 6 variables, el impacto que tiene el posoperatorio de la nefrectomía laparoscópica en los donantes vivos con respecto al resto de pacientes que se someten al mismo procedimiento por otras causas en nuestra unidad. El objetivo principal del estudio es analizar las implicaciones y el impacto que tiene el posoperatorio de la nefrectomía laparoscópica en los diferentes procesos. Se parte de la hipótesis de que las implicaciones que tiene el donante vivo afectarán al desarrollo de su posoperatorio (mayor dolor, mayor estancia hospitalaria...), comparado con el resto de pacientes que se someten a la misma intervención por otros motivos. Se identificó en este estudio que este tipo de cirugía implica mayor estancia hospitalaria, con respecto a la misma cirugía por otros motivos, pero no existe un resultado en el número de pacientes estudiados de mayor dolor en estos pacientes con respecto a los otros citados. Mostraremos los cuidados enfermeros que seguimos en nuestra unidad con estos pacientes. Para ello tomaremos como referencia los patrones funcionales de Gordon, determinando los diagnósticos enfermeros, así como los criterios de resultados (NOC) y las intervenciones de enfermería (NIC)
Due to the increase of laparoscopic nephrectomy in live donors for renal transplantation during the last years in our hospital (in 2017, 332 live donor renal transplants, of these 47 were done in Andalusia, and 17 in our hospital). A prospective study was conducted to analyse 6 variables, the Impact of postoperative laparoscopic nephrectomy in live donors compared to those patients who underwent the same procedure for different reasons in our unit. The primary aim of the study is to examine the implications and impact of postoperative laparoscopic nephrectomy in different processes. It is assumed that the live donor's implications will affect the postoperative period (pain, length of hospital stay...), compared to the rest of the patients who undergo the same procedure for different reasons. A study identified that this type of surgery involves unnecessarily prolonged stay in hospital, with regards to the same surgery but for different reasons. However, there is no evidence of difference between the number of patients studied with severe pain and the aboye mentioned. We will show the nursing care that we follow with these patients in our unit. We will take as reference Gordon's functional health patterns, identifying nursing diagnosis as well as the nursing outcomes classification (NOC) and nursing interventions
Asunto(s)
Humanos , Masculino , Femenino , Nefrectomía/métodos , Donadores Vivos , Laparoscopía/enfermería , Cuidados Posoperatorios/enfermería , Diagnóstico de Enfermería , Nefrectomía/enfermería , Trasplante de Riñón/enfermería , Estudios ProspectivosRESUMEN
La atención sanitaria basada en la evidencia y su aplicación a través de herramientas para la disminución de la variabilidad de la práctica clínica es fundamental en la práctica diaria. Con esta comunicación mostramos el uso de la técnica de la ablación percutánea por radiofrecuencia de tumores renales. Mostraremos los cuidados enfermeros seguidos en la unidad para mejorar la calidad de los cuidados. Tomamos como muestra tres casos clínicos de nuestro servicio. Describiremos todos los cuidados que se realizan para la atención integral de enfermería, realizando un seguimiento de los mismos. Para ello tomaremos como referencia los patrones funcionales de Gordon, determinando los diagnósticos enfermeros, así como los criterios de resultados (NOC) y las intervenciones de enfermería (NIC)
Evidence base-health care and its application through tools to decrease the variability of the clinical practice is of pivotal importance in the daily practice. The aim is to show percutaneous ablation technique by means of radiofrequency of renal tumours. Nursing care plan followed in the unit is shown. As an example, three clinical cases are presented. Comprehensive nursing care is described with a close monitoring of the situation. Gordon is the method used in the nursing process to provide a more comprehensible nursing assessment of the patient (diagnosis, nursing outcomes classification and Nursing Interventions Classification)
Asunto(s)
Humanos , Masculino , Anciano , Neoplasias Renales/terapia , Tratamiento de Radiofrecuencia Pulsada , Ablación por Catéter , Atención de EnfermeríaRESUMEN
Debido al incesante aumento de las infecciones asociadas a los catéteres de acceso venosos periféricos y centrales que enfermería utiliza, añadiendo la importancia de la prevención de las mismas como línea de actuación dentro de las guías FASE (Fáciles y Seguras basadas en la Evidencia), vemos importante la introducción de cambios en el hacer de nuestra profesión. Por ello se implantó en nuestra unidad el uso de tapones protectores impregnados en alcohol que, colocándolos en los puertos denominados bioconectores, los dejaban no solo aislados del medio, sino que se consideran desinfectados. Durante 21 días hicimos un seguimiento de quiénes de los pacientes candidatos de usarlo lo tenían y quiénes no. Y finalmente pasamos unas encuestas de valoración para evaluar el rendimiento global del producto en comparación con el sistema anterior de desinfección. Para observar si nuevas medidas de asepsia en el uso de dispositivos venosos eran aceptadas y valoradas. Observando un gran nivel de adhesión
Because of the ever-increasing infections associated with peripheral and central venous catheters, added the importance of prevention which constitutes a line of action of the simple and safety guides based on Evidence (FASE guides), used by nursing staff it is important to introduce changes in this profession. Therefore, a policy of port protectors which are alcohol-impregnated caps is also necessary since they are a physical barrier to contamination and guarantee disinfection compliance. For 21 days we conducted a study to determine the appropriate candidates. Finally, we conducted an assessment survey to evaluate the overall performance of the product in comparison with the previous method of disinfection to be able to check is new measures of asepsis with regards to the use of venous access devices were well accepted and valued. Noting great level of satisfaction
Asunto(s)
Humanos , Infecciones Relacionadas con Catéteres/prevención & control , Desinfectantes/administración & dosificación , Evaluación en Enfermería , Atención de Enfermería , Estudios Longitudinales , Estudios ProspectivosRESUMEN
Dada la importancia de una adecuada atención de enfermería, así como del uso de planes de cuidados estandarizados para la mejora de dichos cuidados, presentamos esta comunicación donde mostramos un caso clínico concreto. Se trata de una mujer de 48 años que ingresa en nuestra planta con el diagnóstico de cistitis actínica o rádica. Para ello tomamos como referencia los patrones funcionales de Gordon, determinando los diagnósticos enfermeros así como los criterios de resultados (NOC) y las intervenciones de enfermería (NIC). Por otro lado, hemos usado la escala tipo Likert con la que hemos evaluado los indicadores propuestos para conseguir nuestros resultados
Given the importance of an adequate nursing work and the development of standardized care plans to improve care practice, we bring forward this communication to present this particular clinical case: a 48-year-old female patient who developed actinic cystitis. To treat this female patient, we use Gordon's functional health patterns. This allows us to provide a comprehensive nursing assessment of the patient to determine nursing outcomes classification (NOC) and to evaluate the effects of interventions (NIC). On the other hand, we have used Likert scale to assess the proposed indicators which will allow us to reach the main goals