Plan de cuidados en un paciente con reagudización de EPOC: a propósito de un caso

[Resumen] Introducción: La Enfermedad Pulmonar Obstructiva Crónica (EPOC) es una enfermedad caracterizada por una persistente limitación del aire, generalmente de carácter progresivo y asociado a una respuesta inflamatoria en las vías respiratorias por inhalación de partículas nocivas o gases, y especialmente asociada al humo del tabaco. Son frecuentes los ingresos hospitalarios por reagudizaciones de la patología. Objetivos: 1) Realizar una valoración exhaustiva de un paciente que permaneció ingresado durante 14 días en la Unidad de Neumología del Complejo Hospitalario Universitario de A Coruña (CHUAC). 2) Establecer un plan de cuidados individualizado; verificar su eficacia y garantizar el seguimiento en el área de Atención Primaria posteriormente. Desarrollo: Se realizó un plan de cuidados individualizado empleando las taxonomías NANDA, NOC y NIC para identificar diagnósticos de enfermería, objetivos e intervenciones enfermeras, respectivamente. Se aplicó el modelo AREA, estableciéndose los diagnósticos “Intolerancia a la actividad” y “Conocimientos deficientes” como diagnósticos principales. Se llevó a cabo un seguimiento del paciente durante los días que permaneció ingresado. Discusión y conclusión: las actividades realizadas mostraron una mejoría del paciente. Aunque los planes de cuidados estandarizados resultan muy útiles en la práctica clínica, debido a las características de esta patología es necesaria la individualización.[Resumo] Introdución: A Enfermidade Pulmonar Obstrutiva Crónica (EPOC) é unha enfermidade caracterizada por unha persistente limitación ao aire, xeralmente de carácter progresivo e asociado a unha resposta inflamatoria nas vías respiratorias por inhalación de partículas nocivas ou gases, e especialmente asociada ao fume do tabaco. Son frecuentes os ingresos hospitalarios por reagudizacións da patoloxía. Obxectivos: 1) Realizar unha valoración exhaustiva a un paciente que permaneceu ingresado durante 14 días na Unidade de Neumoloxía do Complexo Hospitalario Universitario A Coruña (CHUAC). 2) Establecer un plan de coidados individualizado; verificar a súa eficacia garantir unha continuidade e seguemento na área de Atención Primaria posteriormente. Desenvolvemento: Realizouse un plan de coidados individualizado empregando as taxonomías NANDA, NOC e NIC para identificar os diagnósticos de enfermaría, obxectivos e intervencións enfermeiras, respectivamente. Aplicouse o modelo AREA, establecendo os diagnósticos “Intolerancia á actividade” e “Coñecementos deficientes” como diagnósticos principais. Levouse a cabo un seguemento do paciente durante os días que permaneceu ingresado. Discusión e conclusión: As actividades realizadas mostraron unha mellora do paciente. Aínda que os plans de coidados estandarizados resultan moi útiles na práctica clínica, debido ás características desta patoloxía é necesaria a individualización.[Abstract] Introduction: The Chronic Obstructive Pulmonary Disease (COPD) is a disease characterised by a persistent limitation of air, usually with a progressive nature, associated to an inflammatory response in the airways due to the inhalation of harmful particles or gases, and especially associated to tobacco smoke. It is a complex and heterogeneous disease that has an impact in the organism as a whole. Admissions to hospitals due to the aggravation of the pathology are very frequent. Objectives: 1) To carry out a comprehensive assessment of a patient that stayed 14 day in the Respiratory Unit in the A Coruña Teaching Hospital Complex (Hospital Universitario de A Coruña – CHUAC). 2) To establish a personalised care plan using taxonomies NANDA, NIC, NOC taxonomies, to subsequently check the success of the activities and guarantee to monitor the Primary Care area. Development: A personalised care plan was executed using the NANDA, NOC and NIC taxonomies to identify nursing diagnosis, objectives and nursing interventions, respectively. The AREA model was applied, and “Intolerance to the activity” and “Inadequate knowledge” were established as the priority diagnosis. A monitoring of the patient was carried out during his stay at the hospital. Discussion and conclusions: The activities did show an improvement in the patient. Although standardised care plans are very helpful in clinical practice, due to the pathology’s characteristics it is necessary to elaborate a personalised care plan.Traballo fin de grao (UDC.ENFC). Enfermaría. Curso 2014/2015

The most common handball injuries: a systematic review

Handball is a team sport involving a great physical demand from its practitioners in which a high number of injuries occur, affecting individual and collective performance. Knowledge of the injuries is of great importance for their prevention. The objective of the present study was to identify, locate and compare the most frequent injuries and injury mechanisms in handball practice. It was carried out following the Preferred Informed Item for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The source of data collection was direct consultation of the PubMed and Medline databases. Several keywords were used for the documentary retrieval, and the quality of the studies that were selected was evaluated. Of the 707 studies retrieved, only 27 were considered appropriate for the review, and quality scores were obtained that ranged from 10 to 26 points, out of a maximum of 28. The most frequent injuries in handball players are located in the lower limbs (thigh, knee and ankle), and in the shoulder in the upper limbs. Regarding the playing position, the players who play over the 6-m line are the most affected by injuries, while the women players have a higher probability of injury. Most injuries occur during competition.Gobierno regional de Extremadura | Ref. GR 2114

Pluronic®/casein micelles for ophthalmic delivery of resveratrol: in vitro, ex vivo, and in vivo tests

Ocular health may strongly benefit from the supply of antioxidant agents that counteract free radicals and reactive oxygen species responsible for long-term eye diseases. Additionally, natural antioxidants like resveratrol can inhibit bacteria growth and restore natural microbiota. However, their use is hindered by limited solubility, fast degradation, and low ocular permeability. This work aimed to overcome these limitations by preparing single and mixed micelles of Pluronic® F127 and casein that serve as resveratrol nanocarriers. Single and mixed (0.1 % casein) micelles (0.0 to −17.0 mV; 2.4 to 32.7 nm) increased 50-fold resveratrol solubility, remained stable for one month at 4 °C, withstood fast dilution, underwent sol-to-gel transitions in the 23.9–27.1 °C range, and exhibited potent antioxidant properties. All formulations successfully passed the HET-CAM assay but showed Pluronic®-casein dose-dependent toxicity in the zebrafish embryo model. Resveratrol-loaded single and mixed micelles (10–15 mM Pluronic® F127) displayed antimicrobial activity against S. aureus and P. aeruginosa. The micelles favored resveratrol accumulation in cornea and sclera, but mixed micelles showed larger lag times and provided lower amount of resveratrol permeated through sclera. In vivo (rabbit) tests confirmed the safety of resveratrol-loaded single micelles and their capability to supply resveratrol to anterior and posterior eye segmentsThe work was supported by MCIN/AEI/10.13039/501100011033 [PID 2020-113881RB-I00 to A.C. and C.A.-L., and PID2020-115121GB-I00 to L.S. and A.B.-I.], Spain, Xunta de Galicia [ED431C 2020/17], and FEDER. M. Vivero-Lopez acknowledges Xunta de Galicia (Consellería de Cultura, Educación e Ordenación Universitaria) for a predoctoral research fellowship [ED481A-2019/120]S

Pluronic®/casein micelles for ophthalmic delivery of resveratrol: In vitro, ex vivo, and in vivo tests

Received 10 July 2022; Received in revised form 3 October 2022; Accepted 7 October 2022Ocular health may strongly benefit from the supply of antioxidant agents that counteract free radicals and reactive oxygen species responsible for long-term eye diseases. Additionally, natural antioxidants like resveratrol can inhibit bacteria growth and restore natural microbiota. However, their use is hindered by limited solubility, fast degradation, and low ocular permeability. This work aimed to overcome these limitations by preparing single and mixed micelles of Pluronic® F127 and casein that serve as resveratrol nanocarriers. Single and mixed (0.1 % casein) micelles (0.0 to −17.0 mV; 2.4 to 32.7 nm) increased 50-fold resveratrol solubility, remained stable for one month at 4 °C, withstood fast dilution, underwent sol-to-gel transitions in the 23.9–27.1 °C range, and exhibited potent antioxidant properties. All formulations successfully passed the HET-CAM assay but showed Pluronic®-casein dose-dependent toxicity in the zebrafish embryo model. Resveratrol-loaded single and mixed micelles (10–15 mM Pluronic® F127) displayed antimicrobial activity against S. aureus and P. aeruginosa. The micelles favored resveratrol accumulation in cornea and sclera, but mixed micelles showed larger lag times and provided lower amount of resveratrol permeated through sclera. In vivo (rabbit) tests confirmed the safety of resveratrol-loaded single micelles and their capability to supply resveratrol to anterior and posterior eye segments.Depto. de Optometría y VisiónFac. de Óptica y OptometríaTRUEFondos FEDER - European Union’s Horizon 2020Ministerio de Ciencia e Innovación de España - MCIN/AEI/10.13039/ 501100011033Xunta de Galicia (España)pu

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease : A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Variscan Metamorphism

Various segments of Variscan crust are currently exposed in Iberia in response to successive tectonic events during the Variscan orogeny itself and subsequent extensional and compressive events during the Alpine cycle, all accompanied by surface erosion, and collectively contributing to their exhumation. We review the main characteristics and geodynamic contexts of the metamorphic complexes developed in Iberia during the Variscan cycle, which include: (i) LP-HT complexes associated to the Cambrian-Early Ordovician rift stage; (ii) HP-LT complexes associated to subduction; and (iii) syn-to-post-collisional, MP and LP/HT complexes from the hinterland to the foreland fold-and thrust belts. All the above contexts are illustrated with case studies. Finally, a review of Variscan metamorphism in the Pyrenees and Catalan Coastal Ranges, located far away from the Rheic suture is also presented