Procalcitonin measurements and non-invasive mechanical ventilation in acute exacerbation of COPD: an appropriate new tool?

Hospitalization of acute exacerbations of chronic obstructive pulmonary disease (Ae-COPD) is a common health care problem. In last decades, non-invasive mechanical ventilation (NIV) is a key cornerstone therapeutic element that have shown influence positively short and long term outcomes in Ae-COPD. Recently, incorporation of new biomarkers as procalcitonin (PCT) to predict requirement of NIV in Ae-COPD is an attractive tool to guide a proper making decision regarding indication of NIV is  scarce

Claves epistemológicas y metodológicas del ultra-realismo. Una mirada a los principios y propuestas de las diferentes escuelas ultra realistas

En el presente artículo, en base a unarevisión bibliográfica, se aborda una escuelacriminológica de nuevo cuño, ínsita en losmovimientos de la izquierda criminológica,el Ultra-Realismo. Se ha desgranado suorigen, necesidad, funcionalidad y propuestasde carácter epistemológico y metodológico.Con ello, se pretende que el lector puedaadoptar una nueva perspectiva criminológicaque le ayude a acercarse con herramientas yconceptos renovados al fenómeno criminal.Asimismo, se finaliza con una breve exposiciónde las diferencias entre la escuela anglosajonay la española. A partir de esta diferenciación,se propone al investigador extender la redultra realista y adaptar la escuela a su entornosociocultural

Radiology findings and non-invasive ventilation response

There is a considerable variation in NIV among hospitals, regions and countries although it is a simple and useful method. Thepatient should be monitored via subjective response (respiratory distress, consciousness, problems related to mask and airflow),physiological responses (respiration rate, respiratory effort, air leakage) and patient-ventilator compliance (gas exchange, pulseoximetry, arterial blood gases). Normalization in respiration rate within 1 or 2 hours after initiation of treatment is one of the mostimportant markers for recovery. The goal is to maintain respiration rate between 20 and 30 breaths/minute. Reduction in intercostaland supraclavicular retractions, paradoxical respiration and sympathetic activity indicate success of treatment. Arterial bloodgases are measured within first 2 hours in order to assess pH and CO2; and as needed thereafter. In general, NIV is assessed byarterial blood gases, hemodynamic parameters and several laboratory tests. There is limited number of studies in NIV. Here, weaimed to assess radiological implications of gas distribution within lung tissue during NIV therapy

Desarrollo y edición en un programa de entrevistas: Coffee and Cigarrettes

The present project intends to present the different stages of preproduction, production and post-production of "Coffee and Cigarrettes". A program that gathers several interviews with renowned personalities from the audiovisual sector. It reflects the different phases of preproduction, production and post-production of the program, focusing more on the latter one, and taking as reference the pilot chapter of "Coffee and Cigarettes".El presente proyecto de TFG tiene la intención de presentar las diferentes fases de preproducción, producción y posproducción de ¿Coffee and Cigarrettes¿. Un programa que recoge diversas entrevistas a personalidades conocidas dentro del sector audiovisual. En él se recogen las distintas fases de la preproducción, producción y posproducción del programa centrándose más en esta última y tomando como referencia el episodio piloto de ¿Coffee and Cigarettes¿.Pérez Esquinas, MA. (2017). Desarrollo y edición en un programa de entrevistas: Coffee and Cigarrettes. Universitat Politècnica de València. http://hdl.handle.net/10251/89707TFG

Predictors of noninvasive ventilation failure in critically ill obese patients: a brief narrative review

   Non-invasive ventilation ( NIV ) has been used successfully for the management of acute respiratory failure (ARF) more often in the last two decades than previously. Unfortunately, NIV can have failure rates ranging from 5% to 50% and patient selection is the key to success. There are particular groups of patients that are more likely to benefit from NIV. For patients with hypoventilation syndrome (OHS) this treatment can be beneficial. This review seeks to evaluate the effectiveness of NIV in acute ARF and determine predictors of NIV failure in morbidly obese patients. Only a few studies have investigated NIV success or failure in these patients. NIV was most often effective when patients were carefully selected. Obese patients who exhibited early NIV failure had a high severity score at admission. In contrast, more than half of hypercapnic patients with decompensated OHS exhibited a delayed but successful response to NIV. Patients with decompensation of OHS had better prognosis and response to NIV than other hypercapnic patients. They required more aggressive NIV settings, a longer time to reduce paCO2 levels , and more frequently a delayed but successful response to NIV which should encourage the use of NIV rather than early intubation. Since clear predictors of NIV failure have not been identified, a strict and prolonged monitoring is mandatory.

Influencia de la accesibilidad y distancia en el consumo de productos sanitarios en una Unidad de Hemodialisis

Objetivo: determinar si la distancia que deben recorrer las enfermeras para acceder a tres productos sanitarios (gasas, apósitos y sueros fisiológicos) influye en la cantidad consumida en el Gabinete de Hemodiálisis de la Fundació Puigvert (2013-2014). Método: estudio cuasiexperimental en el total de las enfermeras del Gabinete de Hemodiálisis (n= 30). Variable principal: consumo de unidades de tres productos sanitarios (gasas, apósitos y sueros fisiológicos). Variable de intervención: distancia a donde se encontraban los productos sanitarios (5, 7 y 9 m), que fue modificada cada dos meses. En el análisis bivariante se utilizó el coeficiente de correlación de Spearman, el test de Wilcoxon y la prueba U Mann Whitney. Resultados: existía una correlación lineal inversa, de manera que a mayor edad o años de profesión, menor consumo de los productos sanitarios estudiados. Al comparar el consumo a los 7 y 9 m versus los 5 m, se vio que era inferior para todos los productos (p< 0,05). El consumo de gasas y apósitos fue mayor (p< 0,05) en el turno de tarde en todas las distancias exploradas. Conclusiones: a mayor distancia de los productos sanitarios suero fisiológico, gasas y apósitos, menor es el consumo de los mismos por parte de las enfermeras. Existe una asociación estadísticamente significativa entre el consumo, la edad y la experiencia, de manera que las enfermeras más jóvenes y con menos experiencia consumen más

Nursing Interventions in Prevention and Healing of Leg Ulcers: Systematic Review of the Literature

Aim: The purpose of this study was to define nursing interventions for patients with venous, arterial or mixed leg ulcers

Influence of accesibility and distance in the consumption of disposable equipment in a hemodialysis unit

The location of the disposable material in a hemodialysis unit is essential to ensure the effectiveness of the circuits and to provide quality in nursing care. The law of the minimum effort may explain how the accessibility and distance of dressing trolleys can influence the consumption of some health care supplies [1,2]. It is necessary for health managers to look for effective strategies that optimize the use of wound care material without reducing the quality of care [1,3]. The objective was to determine whether the distance that nurses have to walk to access the trolley with the wound care material (gauzes, dressings and 10cc physiological serum), influence on the amount consumed in a hemodialysis unit at the Fundació Puigvert. The research hypothesis is: consumption of those materials will decrease 5% as the distance to access the trolleys increases from 5 to 7 and from 7 to 9 meters