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Objectives: This paper aims to conduct a review of current scientific evidence on therapeutic hypothermia (TH) induced after cardiac arrest (CA).To examine the published literature; existing nursing knowledge; and the pursuit of the proper role of nursing. Background: CA is a problematic health status with a high associated mortality rate. Cardiopulmonary resuscitation (CPR) techniques have increased the number of patients who recover spontaneous circulation, whereas, mortality in intensive care units (ICU) arising from the neurological damage produced, remains very high. Induced TH is defined as a protective factor against neurological damage resulting from the CA and CPR, but despite the recommendations on its use in the management of post-cardiac arrest syndrome, there is little rigour in its use, little nurse standardisation, and a lack of protocols in our ICU. Search strategy: The databases which can be accessed are: Medline, Pubmed, Ocenet Health, Cochrane Library Plus, Cuiden, Scielo, and electronic platforms Elsevier, OVID and ProQuest. The following keywords were used to start the search: "Hypothermia, Induced", "Heart Arrest", "Nursing". Inclusion and exclusion criteria: only evidence published since 2005, regardless of the output language, focusing on those works involving nursing. Conclusions: This work shows clear evidence of the use of TH induced after CA, and the literature and knowledge required for nursing to interpret their own role, and to introduce standardised protocols for ICUs. © 2011 Elsevier España, S.L. y SEEIUC. Source

Cobo P.A.,Hospital Universitario Infanta Leonor
Revista de la Sociedad Espanola de Enfermeria Nefrologica | Year: 2013

Currently has increased the use of tunneled catheters as permanent vascular access for hemodialysis patients despite having associated complications, such as bacteremia. The aim of this work is to show the incidence of catheter-related bacteremia for hemodialysis obtained with the strict implementation of a protocol tunneled catheter care by well-trained personnel in the Hemodialysis Unit of University Hospital Infanta Leonor between April 2008 and April 2013, and to describe possible causes of bacteremia, the relationship with any of the variables and their evolution in recent years. During 5 years of study there had been 9 episodes of catheter-related bacteremia which is an overall incidence rate of 0.25 / 1000 catheter days. The fee for each of the years was less than 1/1000 catheter days. Patients who had bacteremia had catheters implanted more than those who had not, and this difference was significant (p = 0.027). No differences were found with respect to age, sex, diabetes mellitus, the Charlson comorbidity index and location of catheters among patients who developed bacteremia from those without. Source

Ginsberg Y.,Karolinska Institutet | Quintero J.,Hospital Universitario Infanta Leonor | Anand E.,Eli Lilly and Company | Casillas M.,Eli Lilly and Company | Upadhyaya H.P.,Eli Lilly and Company
Primary Care Companion to the Journal of Clinical Psychiatry | Year: 2014

Objective: To raise awareness of attention-deficit/hyperactivity disorder (ADHD) as an underdiagnosed, undertreated, often comorbid, and debilitating condition in adults. Data Sources: PubMed was searched using combinations of keywords, including ADHD, adult, diagnosis, identify, prevalence, and comorbid, to find articles published between 1976 and 2013. Study Selection: In total, 99 articles were selected for inclusion on the basis of their relevance to the objective and importance to and representation of ADHD research, including international guidelines for adults with ADHD. Results: In a large proportion of children with ADHD, symptoms persist into adulthood. However, although adults with ADHD often experience chaotic lifestyles, with impaired educational and vocational achievement and higher risks of substance abuse and imprisonment, many remain undiagnosed and/or untreated. ADHD is usually accompanied by other psychiatric comorbidities (such as major depressive disorder, anxiety disorder, and alcohol abuse). Indeed, adults with ADHD are more likely to present to a psychiatric clinic for treatment of their comorbid disorders than for ADHD, and their ADHD symptoms are often mistaken for those of their comorbidities. Untreated ADHD in adults with psychiatric comorbidities leads to poor clinical and functional outcomes for the patient even if comorbidities are treated. Effective treatment of adults' ADHD improves symptoms, emotional lability, and patient functioning, often leading to favorable outcomes (eg, safer driving, reduced criminality). A few medications have now been approved for use in adults with ADHD, while a multimodal approach involving psychotherapy has also shown promising results. Conclusions: General psychiatrists should familiarize themselves with the symptoms of ADHD in adults in order to diagnose and manage ADHD and comorbidities appropriately in these patients. © 2014 Physicians Postgraduate Press, Inc. Source

Corella F.,Hospital Universitario Infanta Leonor | Del Cerro M.,Hand Surgery Unit | Larrainzar-Garijo R.,Hospital Universitario Infanta Leonor | Larrainzar-Garijo R.,Complutense University of Madrid | Vazquez T.,Complutense University of Madrid
Journal of Hand Surgery: European Volume | Year: 2011

We present an anatomical study and description of a new surgical technique for arthroscopic treatment of scapholunate ligament injuries. Five cadaver specimens were used to perform the technique. After arthroscopic surgery, anatomic dissection was performed to measure the distances to critical wrist structures such as the posterior interosseous nerve and the radial artery, and the size and position of the plasty. This arthroscopic technique offers three advantages: soft tissue damage is reduced (avoiding an extensive approach and injury to the secondary stabilizers and reducing scar tissue); injury to the posterior interosseous nerve is avoided (maintaining wrist proprioception and the role of the dynamic stabilizers); and a biotenodesis is made that ensures proper placement, tension and functionality of the flexor carpi radialis ligament reconstruction. © The Author(s) 2011. Source

Ripolles J.,Hospital Universitario Infanta Leonor | Marmana Mezquita S.,Hospital Universitario Moises Broggi | Abad A.,Hospital Universitario La Paz | Calvo J.,Hospital Universitario Infanta Leonor
Revista Brasileira de Anestesiologia | Year: 2015

Background: The transverse abdominal plan blockade (TAP) is a block of abdominal wall that has diffused rapidly in the clinical practice as part of a multimodal analgesia for abdominal surgery. The performance of the ultrasound-guided technique has allowed the lowering of potential complications, as well as new approaches that according to the descriptions carried out and the prospective studies would make it possible to utilize the TAP in different surgical interventions; however, the results obtained in randomized clinical trials (RCTs) are inconsistent. Objectives: To prepare a systematic review aiming to determine the efficacy of the ultrasound-guided TAP for different surgical interventions, as well as the indications according to the approaches and their influences. Methods: Two research approaches, one manual, and the other in Pubmed returned 28 RCT where an intervention with ultrasound-guided TAP were performed to compare the analgesic efficacy in contrast to another technique in adults, published between 2007 and October 2013, in English or Spanish, with Jadad score > 1, according to the inclusion criteria for this review. The authors analyzed independently all the RCT. Conclusions: The TAP have been shown to be an effective technique in colorectal surgery, cesarean section, cholecystectomy, hysterectomy, appendectomy, donor nephrectomy, retropubic prostatectomy, and bariatric surgery. However, the data found in RCT are not conclusive, and as a result, it is necessary to develop new and well designed RCT, with enough statistical power to compare different approaches, drugs, doses, and volumes for the same intervention, aiming to answer the current questions and their effects in the habitual clinical practice. © 2014 Sociedade Brasileira de Anestesiologia. Source

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