Posicionamento bioético dos profissionais de saúde espanhóis: Um estudo semi-quantitativo

The present study was undertaken to examine the positions of Spanish health professionals on a variety of bioethical issues and to determine the relationships between these positions and the professionals’ religious beliefs and political views. The study sample consisted of 50 individuals randomly selected from a database of Spanish health professionals who had received solid training in bioethics. A structured questionnaire was designed that contained six closed questions on positions on biomedical advances and science and biotechnology (eugenics, use of nonimplanted embryos for experimental purposes, human cloning, and the idea that science should have limits) and the respondents’ sociopolitical and religious views, and assessment scales were developed for the responses. The distribution of the responses was subjected to statistical analysis using analysis of variance (ANOVA). For the items with responses scored on a Likert scale, the positions taken were moderately adverse, and the vast majority of respondents believed that there should be limits to science. Religious convictions had greater influence on the responses than political orientation. There was evidence that liberal beliefs corresponded with what the authors consider to be more progressive ideas about the bioethics issues addressed in the study. The important questions of bioethics require an interdisciplinary approach and a combination of state and private-sector action to strengthen the links between religion and science, keep general knowledge up to date, and properly train biotechnology professionals.Se realizó el presente estudio para examinar las posiciones de profesionales de la salud española sobre una variedad de temas bioéticos y determinar las relaciones entre estas posiciones y las creencias religiosas y puntos de vista políticos de los profesionales. La muestra del estudio consistió de 50 individuos seleccionados al azar de una base de datos de profesionales de la salud en España que habían recibido formación sólida en bioética. Se diseñó un cuestionario estructurado con seis preguntas cerradas sobre posiciones acerca de avances biomédicos, de ciencia y biotecnología (eugenesia, uso de embriones no implantados para propósitos experimentales, clonación humana y la idea de que la ciencia debería tener límites), y los puntos de vista sociopolíticos y religiosos de los respondientes, y se desarrollaron escalas de evaluación para las respuestas. Se sometió la distribución de las respuestas a análisis estadístico usando análisis de varianza (ANOVA). Para los elementos con respuestas valuadas con una escala Likert, las posiciones tomadas fueron moderadamente adversas y la inmensa mayoría de los respondientes creían que debería haber límites para la ciencia. Las convicciones religiosas tuvieron mayor influencia en las respuestas que la orientación política. Hubo evidencia de que las creencias liberales se correspondieron con las que el autor consideraba ideas más progresistas sobre temas de bioética abordados en el estudio. Las preguntas importantes de bioética requieren una aproximación interdisciplinaria y una combinación de acción estatal y del sector privado para fortalecer los vínculos entre religión y ciencia, mantener el conocimiento general actualizado y formar apropiadamente a los profesionales de la biotecnología.O presente estudo foi realizado para examinar a posição de profissionais de saúde da Espanha sobre uma variedade de temas bioéticos e determinar a correlação entre estas posições e crenças religiosas dos profissionais e pontos de vista políticos. A amostra estudada consistiu de 50 indivíduos selecionados aleatoriamente da base de dados de profissionais de saúde da Espanha que receberam sólido treinamento em bioética. Um questionário estruturado foi definido para conter seis questões fechadas sobre posições a cerca de avanços biomédicos, ciência e biotecnologia (eugenia, utilização de embriões não implantados para projetos experimentais, clonagem humana e a ideia de que a ciência deveria ter limites) e os pontos de vista sociopolítico e religioso dos respondentes, e escalas de avaliação foram desenvolvidas para as respostas. A distribuição das respostas foi objeto de análises estatísticas utilizando a análise de variância (ANOVA). Para os itens com respostas computadas pela escala de Likert, desde de ‘concorda fortemente’ a ‘discorda fortemente’, as posições tomadas foram moderadamente adversas, e a vasta maioria dos respondentes acreditaram que deveria haver limites para a ciência. Convicções religiosas tiveram maior influência nas respostas do que aquelas de orientação política. Houve evidência de que crenças liberais corresponderam com o que os autores consideram ser ideias mais progressistas sobre temas bioéticos direcionados pelo estudo. As importantes questões de bioética requerem uma abordagem interdisciplinar e uma ação combinada dos setores público (estatal) e privado para revigorar os elos entre religião e ciência, manter um conhecimento geral atualizado, e treinar adequadamente profissionais em biotecnologia

An unusual presentation of postaxial polydactyly of the foot

[Abstract] A 6-month-old Caucasian baby is described with a postaxial polydactyly of the letf foot. Radiographic examination revealed the accessory digit was composed of soft tissue, some with a tiny osseous element, originated from around the metatarsophalangeal joint, defined by floating type (FT). The parents had consistent difficulty putting shoes. We encountered an exceedingly rare presentation of FT, to our inspection, had neither been previously related in published studies. To the best of our knowledge, this represents the unusual case of congenital deformity lesion on the left foot to be reported in the medical literature

Plasma rich in growth factors (PRGF)

In most of the cases the objective of the medical research it is not centered solely in prolonging the time of life of the patient, but in improving the quality of he himself. Rich Plasma in Growth Factors is a novel and relatively recent technique applicable to the tissue repair. It consists of a simple system for the platelets proteins obtaining from a blood sample of the patient. In the scope of the podiatry, the application of PRGF allows to improve the evolution of patients with titular regenerative necessities in the foot and lower limb such as: to accelerate the osseous consolidation in the postoperative period, to shorten the time of resolution in diabetic ulcers or to improve the healing among other many. Diverse studies on the application of Factors of Growth have demonstrated excellent results in different medical specialties between which is the podiatry, therefore considers a technique of high effectiveness and clinical interest for their contribution to the scientific community.In most of the cases the objective of the medical research it is not centered solely in prolonging the time of life of the patient, but in improving the quality of he himself. Rich Plasma in Growth Factors is a novel and relatively recent technique applicable to the tissue repair. It consists of a simple system for the platelets proteins obtaining from a blood sample of the patient. In the scope of the podiatry, the application of PRGF allows to improve the evolution of patients with titular regenerative necessities in the foot and lower limb such as: to accelerate the osseous consolidation in the postoperative period, to shorten the time of resolution in diabetic ulcers or to improve the healing among other many. Diverse studies on the application of Factors of Growth have demonstrated excellent results in different medical specialties between which is the podiatry, therefore considers a technique of high effectiveness and clinical interest for their contribution to the scientific community

Effectiveness of calcaneal osteotomy in surgical treatment of foot conditions: A Prisma statement guidelines compliant systematic review

[Abstract] Calcaneal osteotomy is a commonly established method used to correct various foot malalignment surgery problems that produce varus and valgus hindfoot abnormality as well as Haglund's deformity, cavovarus foot reconstruction, flatfoot deformity, plantar fasciitis, posterior tibial tendon insufficiency and planovalgus foot. After decades, several procedures in orthopaedic foot surgery have been suggested for reducing the risk of wound and neurovascular complications. The goal of this Prisma statement guidelines compliant systematic review was to establish the effectiveness and safety of calcaneal osteotomy in foot surgery. We have performed a novel systematic review of the current published literature in order to evaluate the scientific evidence now available on this association, assigning predefined exclusion and inclusion criteria. Eight investigations were selected which had 191 cases. The adult flatfoot, tibialis posterior reconstruction and cavovarus foot deformity were treated with different procedures of calcaneal osteotomy techniques. The adequate level of effectiveness of calcaneal osteotomy is associated with the kind and location of the incision, with or without screw application, in each specific foot condition. There is a limited number of scientific investigations of the effectiveness and safety of the different kinds of calcaneal osteotomy in foot surgery, and there is the need to enhance outcome knowledge on this foot surgery technique

Effectiveness of the Lapidus plate system in foot surgery: APRISMA compliant systematic review

[Abstract] Lapidus arthrodesis is an established standard procedure to correct various footsurgery problems and hallux limitus, hypermobility of the first ray, halluxabductus valgus, and symptomatic lesser metatarsal. After decades, many fixa-tion methods in the orthopaedic surgery industry have been developed fordecreasing complications and improving this technique. The aim of this PRI-SMA compliant systematic review is to analyse the effectiveness of several lapi-dus plate systems in foot surgery. We have carried out the first systematicreview of the relevant published literature so as to systematically evaluate thescientific knowledge available now on this association, assigning predefined eli-gibility criteria. Fourteen studies were selected which had an overall of 738cases. The first tarsal metatarsal joint and hallux valgus were treated by theapplication of different types of Lapidus plate system. The optimal level of thefixation in these procedures is related with the type and system insertion placeof the plate with or without screw in each specific foot disease. There is an insuf-ficient number of studies about the effectiveness of the different types of Lapidusplate system in foot surgery, and there is a need to increase outcomes knowledgeon the level of the fixation, sort of the system, and insert place in foot surgery

Extensor Hallucis Capsularis o Tendón Accesorio del Extensor Hallucis Longus: Estudio anatómico y funcional, frecuencia y mediciones

The purpose of this study was to look closely at the anatomy of the extensor hallucis longus, ligament or tendon capsularis Accessory Extensor hallucis longus muscle; defi ne its occurrence frequency, it is a muscle that is not present in all feet and raises controversy in the reviewed literature. The ligament is a ligament capsularis dorsalis pedis group that accompanies the extensor hallucis longus muscle medial to it forever. We intend to demonstrate by our dissections, a ligament more common than it seems and where is its origin and insertion as well as their function, presentation and location by using photographs of cadaver feet and its width measures and characteristics. To achieve our object of study in this article, fi rst 50 dissected human cadaver fi ngers, making the relevant measurements.El objeto de éste estudio fue observar detenidamente la anatomía del Extensor Hallucis Longus, Ligamento Capsularis o Tendón Accesorio del músculo Extensor Hallucis Longus; definir su su frecuencia de aparición, pues es un músculo que no está presente en todos los pies y suscita controversia en la bibliografía consultada.El Ligamento Capsularis es un ligamento del grupo dorsal del pie, que acompaña al músculo Extensor Hallucis Longus siempre medial a él.Pretendemos demostrar con nuestras disecciones, que es un ligamento más habitual de lo que parece y, dónde está su origen e inserción, así como su función, presentación y ubicación mediante fotografías en pies de cadáver, así como medidas sobre su anchura y características particulares.Para conseguir nuestro objeto de estudio en éste artículo, se diseccionan 50 primeros dedos de cadáver humano, realizando las pertinentes mediciones

Hypertrophy of the Trochlearis Calcanei: Etiology, clinical manifestations and treatment

El diagnóstico de una hipertrofia de la tróclea o tuberosidad peroneal del calcáneo se asocia a una tenosinovitis estenosante del tendón del músculo Peroneo Largo o Corto. Hay autores que plantearon que la hipertrofia de la tróclea del calcáneo no provocaba dolor por si misma sino que se produce una exacerbación del dolor cuando el paciente utiliza un zapato que comprime el pie afecto, lo cual produce una irritación en la piel por la compresión a la que ésta estaba sometida, acompañada muchas veces por una afectación sensitiva superficial por atrapamiento del nervio Dorso Cutáneo Lateral.The diagnosis of troclear hypertrophy or fibular tuberosity of calcaneus is associated to stenotic tenosinovitis of long or short the peroneal tendon. There are authors states that troclear hypertrophy of calcaneus did not cause pain by itself but the pain increase when the patient uses a tight shoe that compresses the area affected, this compression produces skin irritation under the area affected accompanied often a sensorial affectation at level of the superficial nerve due to entrapment of dorso cutaneous lateral nerve

NURSE ATTITUDES IN RELATION TO HEALTH CARE ETHICS AND LEGAL REGULATIONS FOR NURSING

Abstract: The nursing environment is full of situations under ethical and legal constraints. Therefore this study focused on the knowledge, position and attitudes of nurses in relation to healthcare ethics and nursing legal regulations. We conducted a pretest and posttest study using a specific questionnaire administered to a convenience sample of nurses who worked in a healthcare system in Principado de Asturias, a northern state of Spain and were enrolled in a continuing nursing education program about ethical and legal aspects in the nursing profession. The main findings suggest that nurses are very concerned about situations that create ethical and legal conflicts but do not feel sufficiently trained. In general, they demonstrated sufficient knowledge to address the most frequent ethical and moral situations of nursing work, and the training received during a postgraduate course in ethics and legislation provided them with greater knowledge and tools to solve the dilemmas In conclusion, although the nurses have university-level education about professional deontology, bioethics and nursing legislation, they require periodic continuing education. Key words: professional ethics, legal aspects, regulation, continual education Actitudes de las enfermeras en relación con la ética de la salud y las regulaciones legales de enfermería Resumen: El ámbito de la enfermería está llena de situaciones clínicas que comportan limitaciones éticas y legales. Por ello, este estudio se centró en demostrar el conocimiento, posicionamiento y actitudes de las enfermeras en relación con la las regulaciones ético legales inherentes a la práctica de enfermería. Se realizó un estudio pretest y posttest, mediante un cuestionario específico administrado a una muestra de conveniencia de las enfermeras que trabajaban en un sistema de salud en el Principado de Asturias de España, y que se habían inscrito en un curso de educación continua sobre los aspectos éticos y legales en la de enfermería profesional. Las principales conclusiones indican que las enfermeras están muy preocupadas por las situaciones que generan conflictos éticos y legales, pero no se sienten suficientemente capacitadas para resolverlas. En general, demostraron conocimientos suficientes para hacer frente a las situaciones ético-morales más frecuentes del trabajo enfermero, y la formación recibida durante un curso de posgrado en la ética y la legislación les proporcionó un mayor conocimiento y herramientas para resolver otros dilemas éticos. En conclusión, aunque las enfermeras tienen conocimientos aprendidos en la universidad sobre deontología profesional, bioética y legislación en enfermería, se requiere de una educación continua en el ámbito ético-legal en enfermería. Palabras clave: ética profesional, aspectos legales, regulación, educación continua Atitudes das enfermeiras com relação à ética em saúde e às regulamentações legais de enfermagem Resumo: O âmbito da enfermagem está cheio de situações clínicas que comportam limitações éticas e legais. Por isso, este estudo se centrou em demonstrar o conhecimento, posicionamento e atitudes das enfermeiras com relação às regulamentações ético-legais inerentes à prática de enfermagem. Realizou-se um estudo pré-teste e pós-teste, mediante um questionário específico administrado a uma amostra de conveniência das enfermeiras que trabalhavam num sistema de saúde no Principado de Astúrias, Espanha, e que se inscreveram num curso de educação continuada sobre os aspectos éticos e legais da enfermagem profissional. As principais conclusões indicam que as enfermeiras estão muito preocupadas com situações que geram conflitos éticos e legais, porém não se sentem suficientemente capacitadas para resolvê-las. Em geral, demonstraram conhecimentos suficientes para fazer frente às situações ético-morais mais frequentes do trabalho de enfermagem, e a formação recebida durante um curso de pós-graduação em ética e legislação lhes proporcionou um maior conhecimento e ferramentas para resolver outros dilemas éticos. Em conclusão, ainda que as enfermeiras tenham conhecimentos aprendidos na universidade sobre deontologia profissional, bioética e legislação em enfermagem, se requer uma educação continuada no âmbito ético-legal em enfermagem. Palavra

Footwear used by older people and a history of hyperkeratotic lesions on the foot : a prospective observational study

4 p.Inadequate footwear, painful and hyperkeratotic lesions (HL) are an extremely common problems amongst older people. Such problems increase the risk of falls, hamper mobility, reduction of quality of life, dignity, and ability to remain independent. The etiology of painful and feet conditions is poorly understood. To discover footwear preferences of older people, pain tolerance may favor presence of HL for the use of inadequate footwear in old age. A sample of 100 participants with a mean age of 74.90 ± 7.01 years attended an outpatient clinic where self-reported demographic data, frequency with which they checked their feet were recorded and measurements were taken of foot sensitivity. Additionally, all participants’ shoes were allocated into optimal, adequate, and dangerous categories based on design, structural and safety features, and materials. Only 12% of the sample population checked their feet every day, 37% revealed symptoms of neuropathy, 14% used optimal shoes, and 61% presented HL. In a bivariate analysis, no significant differences were observed. HL are associated with inadequate footwear, loss of sensitivity, and low frequency of foot health checks.S