EXPERIENCIAS, PERCEPCIONES Y NECESIDADES EN LA UCI: REVISIÓN SISTEMÁTICA DE ESTUDIOS CUALITATIVOS.

Introduction: The intensity of the experience that represents going through an Intensive Care Unit is undeniable. A focus of phenomenological type using qualitative methodology can provide us with a relevant view. The objective of our study is to gather the experiences and patient families and nurses needs in the ICU. Methodology: Qualitative systematic revision meta-study. Presentation of 21 studies. Results: The following categories have been used: Patient experiences, patient needs, stress and confrontation strategies; family experiences, family needs; related nurse-family; nurses regarding the experiences of the patient family; nurses experiences; nurses image. Conclusion: The patient-families demand information, an open visit system, personalized attention, human treatment… Nurses demand a wider training in social abilities. The sanitary administration should also consider the family like an attention nucleus in the ICU, providing resources for it.Introducción. La intensidad de la experiencia que supone pasar por una Unidad de Cuidados Intensivos es innegable. Un enfoque de tipo fenomenológico empleando la metodología cualitativa nos puede proporcionar una acertada visión de la misma. El objetivo de nuestro trabajo es recopilar las vivencias, necesidades de los pacientes-familias y enfermeras de estas unidades. Metodología. Metaestudio tipo revisión sistemática cualitativa. 21 estudios incluidos. Resultados. Se han agrupado en las categorías: experiencias del paciente, necesidades del paciente, estrés y estrategias de afrontamiento; vivencias de la familia, necesidades de la familia; relaciones enfermera-familia; las enfermeras respecto a las vivencias del paciente-familia; vivencias de las enfermeras; imagen de las enfermeras. Conclusión. Los pacientes-familias demandan información, un sistema abierto de visitas, atención personalizada, humanización… Las enfermeras demandamos una formación más amplia en habilidades sociales. La gestión sanitaria debe considerar también a la familia como núcleo de atención en estas unidades, proporcionando recursos para ello

Impacto del policonsumo de drogas sobre varias medidas de memoria prospectiva en una muestra de estudiantes universitarios

El consumo prolongado de drogas se ha asociado a déficit neuropsicológicos y cognitivos. Los déficits más importantes están asociados con las funciones ejecutivas y los problemas de memoria, y en concreto con la memoria prospectiva (MP). Este tipo de memoria juega un papel central en nuestra vida diaria. Sin embargo, faltan estudios sobre los efectos del policonsumo de drogas en la MP. En este estudio pretendemos conocer en qué medida los años desde el inicio de su consumo y la cantidad de consumo estimada de alcohol, tabaco, cannabis y tranquilizantes predicen las puntuaciones autoinformadas de memoria prospectiva y las puntuaciones objetivas en dos tareas experimentales diseñadas por nosotros. Entre las medidas se incluyeron una versión en español del UEL Recreational Drug Use Questionnaire, el Prospective Memory Questionnaire, junto con las puntuaciones objetivas en dos tareas experimentales. La muestra estuvo compuesta por 164 participantes (145 mujeres y 19 varones) con edades comprendidas entre los 19 y 36 años (M: 19.85 años, DE: 2.21). Los análisis de regresión por pasos mostraron que los años de consumo de cannabis explican un 13% de los problemas autoinformados de MP a largo plazo medidos con el PMQ. En el caso de los problemas autoinformados de MP con pistas internas, son los años de consumo de alcohol los que mayor porcentaje de la varianza explican (18.4%). Respecto a las tareas objetivas de MP, los años de consumo de alcohol y la cantidad estimada de alcohol predicen el 30.2% de la varianza de la tarea prospectiva de eventos. El 33.7% de la tarea de MP de tiempo era predicha por la cantidad estimada de consumo de tranquilizantes y de tabaco

Influence of age on the occurrence of adverse events in rheumatic patients at the onset of biological treatment : Data from the BIOBADASER III register

To assess whether age, at the beginning of biologic treatment, is associated with the time a first adverse event (AE) appears in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), or psoriatic arthritis (PsA). All patients in the BIOBADASER registry diagnosed with RA, AS, and PsA, and classified as young ( 75 years old) at start of biological treatment were included. Factors associated with the appearance of a first AE using adjusted incidence rate ratios (IRR) (Poisson regression) were analyzed. Survival to first AE was studied by Kaplan-Meier analysis and hazard ratios (HR) by Cox regression. 2483 patients were included: 1126 RA, 680 PsA, and 677 AS. Age group stratification was as follows: 63 young, 2127 adults, 237 elderly, and 56 very elderly. Regression model revealed an increased probability of suffering a first AE at age 65 years or older [IRR elderly: 1.42 (CI95% 1.13-1.77)]. Other characteristics associated with AE were female gender, the use of DMARDs, including methotrexate, the presence of comorbidities, and the time of disease duration. Factors that had the greatest impact on survival over a first AE were age > 75 years [HR 1.50 (1.01-2.24)] and female gender [HR 1.42 (1.22-1.64)]. Age at the start of treatment and female gender are key factors associated with the appearance of a first AE with biologics. Other factors related to patient status and treatment were also associated with a first AE in rheumatic patients treated with biologics

Aportaciones a la flora de Galicia, VIII

Se citan 37 plantas de variado interés para la flora gallega. Se incluyen 8 novedades de carácter regional (Pteris incompleta Cav., Potentilla recta L., Myriophyllum spicatum L., Solanum sisymbrifolium Lam., Knautia integrifolia (L.) Bertol., Senecio inaequidens DC. Melica arrecta G. Kunze y Stipa clausa Trab.), 17 novedades provinciales (Vandenboschia speciosa (Willd.) G. Kunkel, Ranunculus bupleuroides Brot., Silene niceensis All., Armeria transmontana (Samp.) Lawr., Alcea rosea L., Crambe hispanica L., Rorippa microphylla (Rchb.) Hyl., Saxifraga lepismigena Planellas, Cytisus commutatus subsp. merinoi Laínz & M. Laínz, Galega officinalis L., Melilotus spicatus (Sm.) Breistr., Calystegia silvatica (Kit.) Griseb., Orobanche hederae Baucher ex Duby, Aegilops triuncialis L., Eleusine tristachya (Lam.) Lam., Gagea nevadensis Boiss. y Paradisea lusitanica (Cout.) Samp.) y 12 de interés corológico pero que no suponen novedad gallega o provincial (Lycopodiella inundata (L.) Holub., Corydalis cava (L.) Schweigg. & Körte, Quercus cerris L., Genista sanabrensis Valdés Berm., Castrov. & Casaseca, Oenothera speciosa Nutt., Ligustrum vulgare L., Stachys sylvatica L., Antirrhinum meonanthum Hoffmanns. & Link, Cynara cardunculus L., Nardus stricta L., Gagea pratensis (Pers.) Dumort. y Narcissus rupicola Dufour). Como en anteriores aportaciones, cada taxon va acompañado de diversos comentarios que indican su relevancia corológica o ecológica

Aportaciones a la flora de Galicia, IX

En este trabajo se mencionan 53 plantas de diverso interés para la flora de Galicia o zonas próximas. Se incluyen 3 novedades para España (Sesamoides minor (Lange) O. Kuntze x S. purpurascens (L.) G. López, Hedychium gardnerianum Sheppard ex Ker-Gawler y Oxalis incarnata L.) y otra para Portugal (Bromus hordeaceus L. subsp. ferronii (Mabille) P.M. Smith), 3 novedades regionales (Oxalis incarnata L., Antirrhinum latifolium Mill., Sisyrinchium striatum Mill.), 16 novedades provinciales (Ranunculus bulbosus L. subsp. aleae (Willk.) Rouy & Fouc. var. adscendens (Brot.) Pinto da Silva, Ranunculus peltatus subsp. peltatus var. microcarpus Meikle, Dianthus laricifolius subsp. merinoi (M. Laínz) M. Laínz, Spartium junceum L., Sanicula europea L., Tordylium maximum L., Euphorbia flavicoma DC. subsp. occidentalis M. Laínz, Campanula medium L., Centaurea melitensis L., Festuca durandoi Clauson in Billot subsp. capillifolia (Pau ex Willk.) Rivas Ponce, Cebolla & M.B. Crespo var. livida (Hack.) Rivas-Ponce, Cebolla & M.B. Crespo, Phalaris minor Retz, Carex distans L., Carex umbrosa Hornem. subsp. umbrosa) y otras 40 de interés diverso, bien ecológico, corológico o taxonómico. También, y a la luz de más información, eliminamos del catálogo de la flora vascular de Galicia Iberis contracta subsp. welwitschii (Boiss.) Moreno y Arctium lappa L. Se lectotipifica Euphorbia polygalifolia subsp. hirta (Lange) M. Laínz y Senecio doria var. subintegrum Merino

Estimation of Admission D-dimer Cut-off Value to Predict Venous Thrombotic Events in Hospitalized COVID-19 Patients: Analysis of the SEMI-COVID-19 Registry

Background: Venous thrombotic events (VTE) are frequent in COVID-19, and elevated plasma D-dimer (pDd) and dyspnea are common in both entities. Objective: To determine the admission pDd cut-off value associated with in-hospital VTE in patients with COVID-19. Methods: Multicenter, retrospective study analyzing the at-admission pDd cut-off value to predict VTE and anticoagulation intensity along hospitalization due to COVID-19. Results: Among 9386 patients, 2.2% had VTE: 1.6% pulmonary embolism (PE), 0.4% deep vein thrombosis (DVT), and 0.2% both. Those with VTE had a higher prevalence of tachypnea (42.9% vs. 31.1%; p = 0.0005), basal O2 saturation <93% (45.4% vs. 33.1%; p = 0.0003), higher at admission pDd (median [IQR]: 1.4 [0.6–5.5] vs. 0.6 [0.4–1.2] µg/ml; p < 0.0001) and platelet count (median [IQR]: 208 [158–289] vs. 189 [148–245] platelets × 109/L; p = 0.0013). A pDd cut-off of 1.1 µg/ml showed specificity 72%, sensitivity 49%, positive predictive value (PPV) 4%, and negative predictive value (NPV) 99% for in-hospital VTE. A cut-off value of 4.7 µg/ml showed specificity of 95%, sensitivity of 27%, PPV of 9%, and NPV of 98%. Overall mortality was proportional to pDd value, with the lowest incidence for each pDd category depending on anticoagulation intensity: 26.3% for those with pDd >1.0 µg/ml treated with prophylactic dose (p < 0.0001), 28.8% for pDd for patients with pDd >2.0 µg/ml treated with intermediate dose (p = 0.0001), and 31.3% for those with pDd >3.0 µg/ml and full anticoagulation (p = 0.0183). Conclusions: In hospitalized patients with COVID-19, a pDd value greater than 3.0 µg/ml can be considered to screen VTE and to consider full-dose anticoagulation. © 2021, Society of General Internal Medicine

Modifiable risk factors associated with prediabetes in men and women: A cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes

Background: Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women. Methods: Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models. Results: Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24). Conclusions: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population

Anisotropic flow of charged hadrons, pions and (anti-)protons measured at high transverse momentum in Pb-Pb collisions at sNN=2.76\sqrt{s_{\rm NN}}=2.76 TeV

The elliptic, $v_2$, triangular, $v_3$, and quadrangular, $v_4$, azimuthal anisotropic flow coefficients are measured for unidentified charged particles, pions and (anti-)protons in Pb-Pb collisions at $\sqrt{s_{\rm NN}} = 2.76$ TeV with the ALICE detector at the Large Hadron Collider. Results obtained with the event plane and four-particle cumulant methods are reported for the pseudo-rapidity range $|\eta|<0.8$ at different collision centralities and as a function of transverse momentum, $p_{\rm T}$, out to $p_{\rm T}=20$ GeV/$c$. The observed non-zero elliptic and triangular flow depends only weakly on transverse momentum for $p_{\rm T}>8$ GeV/$c$. The small $p_{\rm T}$ dependence of the difference between elliptic flow results obtained from the event plane and four-particle cumulant methods suggests a common origin of flow fluctuations up to $p_{\rm T}=8$ GeV/$c$. The magnitude of the (anti-)proton elliptic and triangular flow is larger than that of pions out to at least $p_{\rm T}=8$ GeV/$c$ indicating that the particle type dependence persists out to high $p_{\rm T}$.Comment: 16 pages, 5 captioned figures, authors from page 11, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/186

Centrality dependence of charged particle production at large transverse momentum in Pb-Pb collisions at sNN=2.76\sqrt{s_{\rm{NN}}} = 2.76 TeV

The inclusive transverse momentum ($p_{\rm T}$) distributions of primary charged particles are measured in the pseudo-rapidity range $|\eta|<0.8$ as a function of event centrality in Pb-Pb collisions at $\sqrt{s_{\rm{NN}}}=2.76$ TeV with ALICE at the LHC. The data are presented in the $p_{\rm T}$ range $0.15<p_{\rm T}<50$ GeV/$c$ for nine centrality intervals from 70-80% to 0-5%. The Pb-Pb spectra are presented in terms of the nuclear modification factor $R_{\rm{AA}}$ using a pp reference spectrum measured at the same collision energy. We observe that the suppression of high-$p_{\rm T}$ particles strongly depends on event centrality. In central collisions (0-5%) the yield is most suppressed with $R_{\rm{AA}}\approx0.13$ at $p_{\rm T}=6$-7 GeV/$c$. Above $p_{\rm T}=7$ GeV/$c$, there is a significant rise in the nuclear modification factor, which reaches $R_{\rm{AA}} \approx0.4$ for $p_{\rm T}>30$ GeV/$c$. In peripheral collisions (70-80%), the suppression is weaker with $R_{\rm{AA}} \approx 0.7$ almost independently of $p_{\rm T}$. The measured nuclear modification factors are compared to other measurements and model calculations.Comment: 17 pages, 4 captioned figures, 2 tables, authors from page 12, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/284

Measurement of charm production at central rapidity in proton-proton collisions at s=2.76\sqrt{s} = 2.76 TeV

The $p_{\rm T}$-differential production cross sections of the prompt (B feed-down subtracted) charmed mesons D$^0$, D$^+$, and D$^{*+}$ in the rapidity range $|y|<0.5$, and for transverse momentum $1< p_{\rm T} <12$ GeV/$c$, were measured in proton-proton collisions at $\sqrt{s} = 2.76$ TeV with the ALICE detector at the Large Hadron Collider. The analysis exploited the hadronic decays D$^0 \rightarrow$K$\pi$, D$^+ \rightarrow$K$\pi\pi$, D$^{*+} \rightarrow$D$^0\pi$, and their charge conjugates, and was performed on a $L_{\rm int} = 1.1$ nb$^{-1}$ event sample collected in 2011 with a minimum-bias trigger. The total charm production cross section at $\sqrt{s} = 2.76$ TeV and at 7 TeV was evaluated by extrapolating to the full phase space the $p_{\rm T}$-differential production cross sections at $\sqrt{s} = 2.76$ TeV and our previous measurements at $\sqrt{s} = 7$ TeV. The results were compared to existing measurements and to perturbative-QCD calculations. The fraction of cdbar D mesons produced in a vector state was also determined.Comment: 20 pages, 5 captioned figures, 4 tables, authors from page 15, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/307