RESUMO
BACKGROUND: CDH1 and CTNNA1 remain as the main genes for hereditary gastric cancer. However, they only explain a small fraction of gastric cancer cases with suspected inherited basis. In this study, we aimed to identify new hereditary genes for early-onset gastric cancer patients (EOGC; < 50 years old). METHODS: After germline exome sequencing in 20 EOGC patients and replication of relevant findings by gene-panel sequencing in an independent cohort of 152 patients, CTNND1 stood out as an interesting candidate gene, since its protein product (p120ctn) directly interacts with E-cadherin. We proceeded with functional characterization by generating two knockout CTNND1 cellular models by gene editing and introducing the detected genetic variants using a lentiviral delivery system. We assessed ß-catenin and E-cadherin levels, cell detachment, as well as E-cadherin localization and cell-to-cell interaction by spheroid modeling. RESULTS: Three CTNND1 germline variants [c.28_29delinsCT, p.(Ala10Leu); c.1105C > T, p.(Pro369Ser); c.1537A > G, p.(Asn513Asp)] were identified in our EOGC cohorts. Cells encoding CTNND1 variants displayed altered E-cadherin levels and intercellular interactions. In addition, the p.(Pro369Ser) variant, located in a key region in the E-cadherin/p120ctn binding domain, showed E-cadherin mislocalization. CONCLUSIONS: Defects in CTNND1 could be involved in germline predisposition to gastric cancer by altering E-cadherin and, consequently, cell-to-cell interactions. In the present study, CTNND1 germline variants explained 2% (3/172) of the cases, although further studies in larger external cohorts are needed.
Assuntos
Caderinas , Cateninas , delta Catenina , Predisposição Genética para Doença , Mutação em Linhagem Germinativa , Neoplasias Gástricas , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologia , Humanos , Masculino , Cateninas/genética , Cateninas/metabolismo , Feminino , Pessoa de Meia-Idade , Adulto , Caderinas/genética , Comunicação Celular , Idade de Início , Antígenos CDRESUMO
Objective: Assess the risk associated with COVID-19 in pregnant women on maternal and neonatal outcomes in Catalonia (Spain) in 2020, before the beginning of COVID-19 vaccination campaign. Method: Cross-sectional descriptive study with all pregnant women (41,560) and their live newborns (42,097) (1st March to 31st December 2020). Women were classified: positive and negative COVID-19 diagnosis during pregnancy. The outcomes analysed were complications during pregnancy, gestational age, admission of newborns to neonatal intensive care unit (NICU) and birth weight. Associations among positive COVID-19 and maternal and infant variables were measured with logistic regression models. Results were expressed as odds ratios and 95% confidence intervals. Models were adjusted for nationality, maternal age, socioeconomic status, type of pregnancy and type of centre where the delivery occurred (public or private management hospital). Results: A total of 696 women (1.7%) were diagnosed with COVID-19 during pregnancy. Women with COVID-19 were 4.37 times more likely to have complications during pregnancy (4.37; 3.52-5.40). A total of 713 newborns (1.7%) were from mothers with COVID-19. A positive diagnosis of COVID-19 increased the risk of preterm birth (1.41; 1.03-1.89), admission to NICU (1.40; 1.06-1.82) and low birth weight (1.35; 0.99-1.80) in babies. Conclusions: Pregnant women with COVID-19 had higher risk of developing complications during pregnancy and their newborns were more likely to be admitted to NICU and had prematurity.(AU)
Objetivo: Evaluar el riesgo asociado de COVID-19 y los resultados en mujeres embarazadas y sus recién nacidos en Cataluña (España) antes del inicio de la campaña de vacunación. Método: Estudio descriptivo transversal de mujeres gestantes (41.560) y sus recién nacidos (42.097) (del 1 de marzo al 31 de diciembre de 2020). Las gestantes fueron clasificadas según diagnóstico COVID-19 positivo o negativo durante el embarazo. Los resultados analizados fueron complicaciones gestacionales, semana gestacional, ingreso del recién nacido en la unidad de cuidados intensivos neonatales (UCIN) y bajo peso al nacer. Las asociaciones entre COVID-19 positivo y variables maternas y perinatales se midieron con regresión logística. Los resultados se expresaron con odds ratio e intervalo de confianza del 95%. Los modelos se ajustaron por nacionalidad, edad materna, nivel socioeconómico, tipo de embarazo y titularidad (pública o privada) del hospital donde se dio a luz. Resultados: Un total de 696 gestantes (1,7%) fueron diagnosticadas de COVID-19 durante el embarazo. Las gestantes con COVID-19 presentaron 4,37 veces mayor probabilidad de tener complicaciones durante el embarazo (4,37; 3,52-5,40). Hubo 713 recién nacidos (1,7%) de gestantes con COVID-19. El diagnóstico positivo de COVID-19 incrementó el riesgo de prematuridad (1,41; 1,03-1,89), ingreso en UCIN (1,40; 1,06-1,82) y bajo peso al nacer (1,35; 0,99-1,80) de los recién nacidos. Conclusiones: Las gestantes con COVID-19 presentaron mayor riesgo de desarrollar complicaciones durante el embarazo y sus hijos tuvieron mayor probabilidad de ingreso en la UCIN y de prematuridad.(AU)
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , /epidemiologia , Gestantes , Recém-Nascido Prematuro , Complicações na Gravidez , Programas de Imunização , /complicações , Espanha , Saúde Pública , Epidemiologia Descritiva , Estudos TransversaisRESUMO
OBJETIVO: Elaborar un listado de medicamentos altamente tóxicos en la infancia (MAT), comercializados en España, diferenciando aquellos que alcanzan la dosis letal para un niño de 10 Kg con la ingesta de 1-3 unidades. MÉTODO: Se definió MAT como aquellos capaces de producir intoxicaciones graves o letales en niños menores de 8 años. Se consideró toxicidad grave la correspondiente al grado 3 en la clasificación Poisoning Severity Score y la categoría «major effects» en las publicaciones de la American Association of Poison Control Centers. Se realizó una revisión bibliográfica de los informes anuales de la American Association of Poison Control Centers y de PubMed entre enero 2000 y febrero 2019 (palabras clave: «severe», «fatal», «life-threatening», «poisoning», «child», «pediatric», «toxicological emergency»). Además, se realizó un estudio observacional retrospectivo de menores de 8 años que consultaron en un servicio de urgencias pediátrico por sospecha de intoxicación farmacológica entre julio 2012 y junio 2018. Se seleccionaron los principios activos responsables comercializados en España y se determinó la dosis letal o la dosis altamente tóxica. Se calculó el número de unidades necesarias para alcanzarla en niños de 10 kg. RESULTADOS: Se identificaron 7 grupos de MAT: analgésicos; psicofármacos y medicamentos neuromusculares; anticatarrales descongestivos-antitusígenos-antihistamínicos-antiasmáticos; medicamentos cardiovasculares; antimicrobianos; preparados tópicos y otros medicamentos. En 29 principios activos, la ingesta de una única unidad podría causar la muerte en un lactante de 10 kg de peso, en 13 podría causarla la ingesta de 2 unidades y en 10 la ingesta de 3 unidades. CONCLUSIÓN: Existen numerosos MAT comercializados en España, algunos de ellos disponibles en presentaciones potencialmente letales con pocas unidades
OBJECTIVE: To prepare a list of highly toxic drugs in infants (HTDs) marketed in Spain, comparing those that reach the lethal dose in a child of 10kg with the ingestion of 1 to 3 units. METHOD: HTDs are defined as those capable of causing severe or lethal poisoning in children less than 8-year-old. Severe poisoning is considered as that corresponding to Grade 3 in the Poisoning Severity Score classification and to the "major effects" category in publications in the American Association of Poison Control Centers. A literature review was carried out on the annual reports of the American Association of Poison Control Centers, as well as in PubMed, between January 2000 and February 2019 (Keywords "severe", "fatal", "life-threatening", "poisoning", "child", "paediatric", "toxicological emergency"). An observational, retrospective study was also conducted on infants less than 8-year-old that were seen in a Paediatric Emergency Department due to suspected drug poisoning between July 2012 and June 2018. The active ingredients responsible marketed in Spain were selected, and the lethal or highly toxic doses were determined. The number of units (pills) necessary to reach this dose in children of 10kg was calculated. RESULTS: A total of 7 HTD groups were identified: analgesics; psychotropics and other medication used in neurological disorders; catarrh decongestants - cough -antihistamine - asthma drugs; cardiovascular drugs; antibiotics, topical preparations, and other drugs. In 29 active ingredients, the ingestion of a single pill could cause death in 10kg infant, in another 13, the ingestion of 2 pills could cause death, as well as the ingestion of 3 pills in 10 cases. CONCLUSION: There are numerous HTDs marketed in Spain, some of which are available in potentially fatal presentations with few pills
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Toxicologia/educação , Intoxicação/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Venenos/toxicidade , Conhecimentos, Atitudes e Prática em Saúde , Relação Dose-Resposta a Droga , Intoxicação/prevenção & controle , Espanha/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Preparações Farmacêuticas/classificação , Estudos RetrospectivosRESUMO
Resumen Este artículo se propone describir algunas de las características de la Ginecología Natural, a partir de la consideración de su desarrollo como expresión sociocultural emergente en la última década en América Latina. Siguiendo los criterios de la teoría fundamentada, se describen dos de las categorías más comunes en una serie de textos escritos y circulados de manera independiente a lo largo del territorio en los últimos cuatro años. Por un lado, el principio informativo y pedagógico, que traza una trama de saberes recuperados y compartidos entre pares. Por el otro, un cuestionamiento constante de la deriva patologizadora y biomedicalizante de la medicina. Los resultados obtenidos permiten esbozar un ideario compartido, pero en constante transformación.
Resumo Este artigo pretende descrever algumas das características da Ginecologia Natural, com base em seu desenvolvimento como expressão sociocultural emergente na América Latina desta última década. Seguindo critérios da teoria fundamentada, são descritas duas das categorias comuns em textos escritos e circulados de maneira independente nesse território, nos últimos quatro anos. Por um lado, o princípio informativo e pedagógico, que mostra um entrelaçamento de saberes recuperados e compartilhados entre pares. Por outro, um questionamento constante da tendência patologizadora e biomedicalizante da medicina. Os resultados obtidos permitem delinear um conjunto de ideias compartilhado e, não obstante, em constante transformação.
Abstract This article tries to describe some of the characteristics of Natural Gynecology, considering its development as a sociocultural expression that emerged in the last decade in Latin America. Following the criteria of the Grounded theory, two of the most common categories in a series of texts written and distributed independently in the last four years are described. On the one hand, the informative and pedagogic principle, combining information brought from ancient knowledge and from the knowledge that is shared among pairs. On the other hand, a constant questioning of the pathologizing and biomedicalizing drift of medicine. The results obtained allow us to sketch a shared ideology, but in permanent transformation.
Assuntos
Humanos , Feminino , Saúde da Mulher , Ginecologia , Medicina Tradicional , Feminismo , Fatores Culturais , Fatores Sociológicos , América LatinaRESUMO
INTRODUCCIÓN: VINCat es un programa de vigilancia de la infección nosocomial en los hospitales de Cataluña. El objetivo del estudio fue evaluar el cumplimiento de las medidas de control de Staphylococcus aureus resistente a meticilina (SARM) en dichos centros. MÉTODOS: De enero a marzo de 2013 se realizó una encuesta por correo sobre las características de los hospitales y la aplicación de las medidas de control de SARM. RESULTADOS: Respondieron 53 hospitales (>500 camas: 7; 200-500 camas: 14;<200 camas: 32; tenían UCI: 29). Disponían de alerta informática de reingresos el 63%. Realizaban vigilancia activa de los traslados de otro hospital el 46,2%, o centro de larga estancia el 55,8%, siendo ambas medidas significativamente más frecuentes en hospitales con una tasa de SARM≤22% (mediana global). Observaban el cumplimento de higiene de manos el 77,4% de los centros y fue mayor al 50% en el 69,7%. Todos los hospitales aplicaban precauciones de contacto, aunque el 62,3% no disponían de material clínico de uso frecuente exclusivo. La limpieza de la habitación se realizaba más frecuentemente en el 54,7% y tenían programas de adecuación del uso de antibióticos el 67,9%. CONCLUSIONES: Este estudio informa sobre la implementación de medidas preventivas de SARM en hospitales del programa VINCat. Aunque la mayoría de los hospitales disponen de un protocolo específico, el cumplimento de las medidas es mejorable, especialmente la detección activa en pacientes de riesgo, la adherencia a la higiene de manos, la limpieza más frecuente de la habitación y la optimización del uso de antibióticos
INTRODUCTION: VINCat is a nosocomial infection surveillance program in hospitals in Catalonia. The aim of the study was to determine the surveillance and control measures of methicillin-resistant Staphylococcus aureus (MRSA) in these centres. METHODS: An e-mail survey was carried out from January to March 2013 with questions related to the characteristics of the hospitals and their control measures for MRSA. RESULTS: A response was received from 53 hospitals (>500 beds: 7; 200-500 beds: 14;<200 beds: 32; had ICU: 29). Computer alert of readmissions was available in 63%. There was active surveillance of patients admitted from another hospital (46.2%) or a long-term-care centre (55.8%), both being significantly more common measures in hospitals with a rate of MRSA≤22% (global median). Compliance with hand hygiene was observed in 77.4% of the centres, and was greater than 50% in 69.7% of them. All hospitals had contact precautions, although 62.3% did not have exclusive frequently used clinical material in bedrooms. The room cleaning was performed more frequently in 54.7% of hospitals, and 67.9% of them had programs for the appropriate use of antibiotics. CONCLUSIONS: This study provides information on the implementation of measures to prevent MRSA in hospitals participating in the VINCat program. Most of the centres have an MRSA protocol, however compliance with it should be improved, especially in areas such as active detection on admission in patients at risk, hand hygiene adherence, cleaning frequency and optimising the use of antibiotics
Assuntos
Humanos , Controle de Doenças Transmissíveis/métodos , Infecções Estafilocócicas/prevenção & controle , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos , Infecção Hospitalar/prevenção & controleRESUMO
OBJETIVO: Conocer la proporción de población potencialmente excluida de cobertura sanitaria a partir del Real Decreto-Ley 16/2012. Describir el uso de servicios sanitarios, la distribución de patología crónica e infecciosa y el gasto farmacéutico en 2012 de las personas excluidas respecto a las que mantendrían su cobertura. Diseño y emplazamiento: Estudio observacional analítico transversal de base poblacional en atención primaria. Gerencia Territorial de la Cataluña Central del Institut Català de la Salut. Participantes y MEDICIONES PRINCIPALES: Se seleccionaron las personas potencialmente excluidas a partir de la aplicación del Real Decreto-Ley 16/2012 y se compararon con las personas que mantendrían su cobertura sanitaria apareadas de forma aleatoria por edad, sexo y servicio de atención primaria. La información obtenida incluyó el uso de servicios sanitarios, la distribución de patologías crónicas e infecciosas y el gasto farmacéutico durante el año 2012. RESULTADOS: Se identificaron 1.699 personas, el 0,53% del total de la población (51,4% hombres), con una mediana de edad de 34 años (rango intercuartílico, 28-43) potencialmente excluidas de cobertura sanitaria. El uso de servicios sanitarios, la morbilidad crónica registrada y el gasto farmacéutico durante el año 2012 de los excluidos fueron inferiores a los de los no excluidos (p < 0,001). En cambio, la morbilidad infecciosa fue superior en los excluidos (p < 0,001). CONCLUSIONES: Los resultados del estudio llevan a pensar que esta medida legislativa no parece justificada por razones médicas ni económicas. Además, podría provocar problemas de salud pública y contribuir al riesgo de fractura social
OBJECTIVE: To assess the proportion of population potentially excluded from healthcare coverage since the Royal Decree-Law 16/2012. To describe the use of health services, the distribution of chronic and infectious diseases, and the pharmaceutical costs in 2012 of the persons potentially excluded compared to the those who maintain their coverage. Design and SETTING: An observational analytical cross-sectional study was designed and conducted on a Primary Care based population in the Central Catalonia Management Area of the Institut Català de la Salut Participants and MAIN MEASUREMENTS: Individuals potentially excluded since the application of the Royal Decree-Law 16/2012 were selected and compared with individuals who maintained their healthcare coverage, randomly matched by sex, age and Primary Care service. The information obtained included the use of health services, the distribution of chronic and infectious diseases, and the pharmaceutical costs during the year 2012. RESULTS: A total of 1,699 individuals were identified as potentially excluded from healthcare coverage, 0.53% of the total of population (51.4% men), with a median of age of 34 years (interquartile range, 28-43). The use of healthcare services, the chronic morbidity recorded, and the pharmaceutical costs during the year 2012 of the excluded individuals was lower than those of the non-excluded ones (P < .001). On the other hand, the infectious morbidity was higher in the excluded individuals (P < .001). CONCLUSIONS: The results of the study suggests that this legislative measure does not seem to be justified for medical or economic reasons. It could also cause public health problems and contribute to the risk of social fracture
Assuntos
Humanos , Masculino , Feminino , Cobertura de Serviços de Saúde/tendências , Cobertura do Seguro/legislação & jurisprudência , Emigrantes e Imigrantes/legislação & jurisprudência , Emigrantes e Imigrantes/estatística & dados numéricos , Atenção Primária à Saúde/legislação & jurisprudência , Cobertura do Seguro/tendências , Cobertura do Seguro , Emigração e Imigração/legislação & jurisprudência , Estudos Transversais/métodos , Estudos Transversais/tendências , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendênciasRESUMO
No disponible
Assuntos
Humanos , Pesquisa Biomédica/ética , Relatório de Pesquisa/legislação & jurisprudência , Prontuários Médicos/legislação & jurisprudência , Big Data , Mineração de Dados/ética , Processamento Eletrônico de Dados/legislação & jurisprudência , Segurança Computacional/legislação & jurisprudência , Confidencialidade/ética , Responsabilidade Legal , 36448RESUMO
OBJETIVO: El presente estudio pretende describir la implementación de los programas de seguridad del paciente (SP) de los hospitales catalanes y analizar el nivel de implicación de las enfermeras. MÉTODO: Estudio descriptivo multicéntrico y transversal. Para la obtención de los datos se elaboraron dos cuestionarios, uno dirigido a la dirección y otro al referente de SP que se distribuyeron entre los 65 hospitales de agudos de Cataluña en 2013. RESULTADOS: El cuestionario lo respondieron 43 direcciones de enfermería y 40 referentes de enfermería de SP. El 93% de los hospitales respondió disponer de programa de SP y el 81,4% monitoriza los resultados mediante un cuadro de indicadores específico. El referente en SP del centro es enfermera en el 55,8% de los centros. El 92,5% disponen de un sistema de notificación de efectos adversos con un promedio de 190,3 notificaciones anuales y el 86% de los centros dedican enfermeras a la SP aunque únicamente el 16% a jornada completa. Los referentes de enfermería valoran el grado de implementación del programa SP con un aprobado y proponen como mejora aumentar el personal con dedicación a SP y disponer de formación académica específica. CONCLUSIONES: El grado de implementación de los programas de SP es elevado en los hospitales catalanes aunque la estructura organizativa presenta una gran diversidad. En más de la mitad de los centros el referente en SP es una enfermera, confirmándose la implicación de las enfermeras en estos programas
OBJECTIVE: This study aims to describe the implementation of the patient safety (PS) programs in catalan hospitals and to analyze the level of nursing involvement. METHOD: Multicenter cross-sectional study. To obtain the data two questionnaires were developed; one addressed to the hospital direction and another to the nurse executive in PS. The survey was distributed during 2013 to the 65 acute care hospitals in Catalonia. RESULTS: The questionnaire was answered by 43 nursing directors and 40 nurse executive in PS.93% of the hospitals responded that they had a PS Program and 81.4% used a specific scoreboard with PS indicators. The referent of the hospital in PS was a nurse in 55.8% of the centres.92.5% had a system of notification of adverse effects with an annual average of 190.3 notifications. In 86% of the centres had a nurse involved in the PS program but only in the 16% of the centres the nurse dedication was at full-time. The nurse respondents evaluate the degree of implementation of the PBS program with a note of approved and they propound as improvement increase the staff dedicated to the PS and specific academic training in PS. CONCLUSIONS: The degree of implementation of programs for patient safety is high in Catalan acute hospitals, while the organizational structure is highly diverse. In more than half of the hospitals the PS referent was a nurse, confirming the nurse involvement in the PS programs
Assuntos
Humanos , Segurança do Paciente/normas , Cuidados de Enfermagem/métodos , Gestão da Segurança/organização & administração , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos , Planos e Programas de Saúde/organização & administraçãoRESUMO
OBJETIVO: La hipotermia terapéutica (HT) se recomienda para minimizar el daño neurológico de pacientes que sobreviven a una parada cardiorrespiratoria (PCR). Existen pocos datos que evalúen la carga de trabajo de Enfermería en estos pacientes. El objetivo del estudio es evaluar la carga de trabajo del personal de Enfermería en pacientes sometidos a HT tras una PCR. MÉTODO: Se diseñó un estudio prospectivo-retrospectivo comparativo de cohortes durante 43 meses donde se incluyeron todos los pacientes ingresados en unidades de cuidados intensivos con PCR recuperada. Se compararon características basales, manejo médico, mortalidad intrahospitalaria, y carga de trabajo de Enfermería en las primeras 96 horas mediante las escalas validadas Therapeutic Intervention Scoring System-28 (TISS-28); Nursing Activities Score (NAS); y Nine Equivalents of Nursing Manpower Use Score (NEMS) entre aquellos pacientes tratados y no tratados mediante HT. RESULTADOS: Se incluyeron 46 pacientes: 26 en el grupo HT y 20 en el grupo no HT. El grupo HT presentó mayor prevalencia de tabaquismo (69 vs. 25%, p = 0,012), PCR extrahospitalaria (96 vs. 55%, p < 0,001) y realización de coronariografías (96 vs. 65%, p = 0,014). No hubo diferencias en la carga de trabajo evaluada por las escalas TISS 28, NAS o NEMS ni tampoco en el pronóstico intrahospitalario. CONCLUSIONES: En este estudio la realización de HT en pacientes que sobreviven a una PCR no se asocia con un aumento de la carga de trabajo de Enfermería. La instauración de programas de HT no requeriría la implementación de más recursos en Enfermería en términos de carga de trabajo
OBJECTIVE: Therapeutic hypothermia (TH) is recommended to minimize neurological damage in patients surviving sudden cardiac arrest (SCA). There is scarcity of data evaluating the nursing workload in these patients. The objective of the study is to assess the workload of nurses whilst treating patients undergoing TH after SCA. METHOD: A 43-month prospective-retrospective comparative cohort study was designed. Patients admitted to intensive care unit, for recovered SCA and persistent coma, were included. A comparison was made using the baseline characteristics, medical management, in-hospital mortality, and nursing workload during the first 96 hours using the Therapeutic Intervention Scoring System-28 (TISS-28); Nursing Activities Score (NAS); and Nine Equivalents of Nursing Manpower Use Score (NEMS) scales among patients who received TH and those who did not. RESULTS: A total 46 patients were included: 26 in the TH group and 20 in the Non-TH group. Regarding baseline characteristics and management, the TH group presented higher prevalence of smoking habit (69 vs. 25%, p = 0 .012), out-of-hospital SCA (96 vs. 55%, p < 0 .001), and the performance of coronary angiography (96 vs. 65%, p = 0 .014) compared with the non-TH group. No differences were observed in the nursing workload, assessed by TISS 28, NAS or NEMS scales, or in-hospital mortality. CONCLUSIONS: In this study performance of TH in SCA survivors is not associated with an increase in nursing workload. The installation of a TH program does not require the use of more nursing resources in terms of workload
Assuntos
Humanos , Hipotermia Induzida/enfermagem , Carga de Trabalho/estatística & dados numéricos , Cuidados de Enfermagem/estatística & dados numéricos , Parada Cardíaca/enfermagem , Morte Súbita Cardíaca , Fatores de RiscoRESUMO
No disponible
Assuntos
Humanos , Transtornos Mentais , Direitos do Paciente/ética , Pessoas Mentalmente Doentes/legislação & jurisprudência , Institucionalização/ética , Autonomia PessoalRESUMO
Artículo que contribuye a la reflexión y debate sobre una cuestión tan difícil y delicada, que requiere un enfoque multidisciplinar y con una debida atención a todos los agentes implicados. El debate sigue abierto y lo fundamental es mantener la capacidad de diálogo y receptividad en aras a alcanzar un consenso social y político sobre el tema
This article leads to reflection and debate about such a difficult and delicate question which requires a multidisciplinary focus and due attention paid to all the agents implicated in euthanasia. This debate remains open and what is fundamental is to maintain the capacity for dialogue and receptiveness in hopes of achieving a social and political consensus regarding this topic