David Armero-Barranco

Use and influence of Delivery and Birth Plans in the humanizing delivery process

520 Objetivos: conhecer, analisar e descrever a situacao atual dos Planos de Parto e Nascimento no contexto estudado, comparando o processo de parto e sua finalizacao entre as mulheres que apresentaram e as que nao apresentaram um Plano de Parto e Nascimento. Metodo: estudo de coorte quantitativo, transversal, observacional descritivo comparativo, realizado durante um bienio. Foram selecionadas todas as mulheres que deram a luz no periodo estudado, incluindo 9303 mulheres. Resultados: o numero de Planos de Parto e Nascimento apresentados no primeiro ano foi de 132, contra 108 no segundo. Entre as variaveis analisadas, foi encontrada uma diferenca significativa para “contato pele a pele”, “eleicao de posicao de dilatacao e parto”, “uso de enema”, “ingestao de alimentos ou liquidos”, “partos normais”, “clampeamento tardio do cordao” e “depilacao do perineo”. Conclusoes: os Planos de Parto y Nascimento influenciam positivamente o processo de parto e sua finalizacao. Sao necessarias politicas sanitarias para aumentar o numero de Planos de Parto e Nascimento apresentados nos hospitais estudados.

Oleanolic acid induces migration in Mv1Lu and MDA-MB-231 epithelial cells involving EGF receptor and MAP kinases activation

During wound healing, skin function is restored by the action of several cell types that undergo differentiation, migration, proliferation and/or apoptosis. These dynamics are tightly regulated by the evolution of the extra cellular matrix (ECM) contents along the process. Pharmacologically active flavonoids have shown to exhibit useful physiological properties interesting in pathological states. Among them, oleanolic acid (OA), a pentacyclic triterpene, shows promising properties over wound healing, as increased cell migration in vitro and improved wound resolution in vivo. In this paper, we pursued to disclose the molecular mechanisms underlying those effects, by using an in vitro scratch assay in two epithelial cell lines of different linage: non-malignant mink lung epithelial cells, Mv1Lu; and human breast cancer cells, MDA-MB-231. In every case, we observed that OA clearly enhanced cell migration for in vitro scratch closure. This correlated with the stimulation of molecular pathways related to mitogen-activated protein (MAP) kinases, as ERK1,2 and Jun N-terminal kinase (JNK) 1,2 activation and c-Jun phosphorylation. Moreover, MDA-MB-231 cells treated with OA displayed an altered gene expression profile affecting transcription factor genes (c-JUN) as well as proteins involved in migration and ECM dynamics (PAI1), in line with the development of an epithelial to mesenchymal transition (EMT) status. Strikingly, upon OA treatment, we observed changes in the epidermal growth factor receptor (EGFR) subcellular localization, while interfering with its signalling completely prevented migration effects. This data provides a physiological framework supporting the notion that lipophilic plant extracts used in traditional medicine, might modulate wound healing processes in vivo through its OA contents. The molecular implications of these observations are discussed.

Roux-en-Y Gastric Bypass: Effective Against Metabolic and Psychiatric Comorbidity?

Background: Roux-en-Y gastric bypass (RYGB) is considered the gold standard for gastric bypass, displaying better results for metabolic disorders than other surgical procedures over the long term. The aim of this study was to determine the effects of bariatric surgery, in particular the RYGB technique, on metabolic syndrome (MS) and other biochemical parameters implicit in the comorbid conditions associated with obesity, as well as to explore the influence of this surgical procedure on psychiatric comorbidity in the study population. Method: An observational retrospective cohort study based on 146 clinical records of patients having undergone RYGB between January 1, 2011, and January 1, 2014, was performed. Data related to metabolic and psychiatric comorbidity were gathered at three stages: prior to surgery and at 3 and 9 months following surgery. Results: There was a progressive and statistically significant reduction of all biochemical parameters analyzed at 3 and 9 months following surgery except high-density lipoprotein cholesterol, which significantly increased (beneficial) in value. These changes imply a remission of >90% for all metabolic disorders and the consequent tendency toward a reduction in prescribed pharmacological treatments, with MS found in only one subject at 9 months. There was, however, no significant reduction in pharmacological treatments for psychiatric comorbidities. Conclusion: Findings suggest that RYGB is an effective treatment for MS and other metabolic disorders but not for psychiatric comorbidities accompanying MS.

Microscopy Based Methods for the Assessment of Epithelial Cell Migration During In Vitro Wound Healing

Cell migration is a mandatory aspect for wound healing. Creating artificial wounds on research animal models often results in costly and complicated experimental procedures, while potentially lacking in precision. In vitro culture of epithelial cell lines provides a suitable platform for researching the cell migratory behavior in wound healing and the impact of treatments on these cells. The physiology of epithelial cells is often studied in non-confluent conditions; however, this approach may not resemble natural wound healing conditions. Disrupting the epithelium integrity by mechanical means generates a realistic model, but may impede the application of molecular techniques. Consequently, microscopy based techniques are optimal for studying epithelial cell migration in vitro. Here we detail two specific methods, the artificial wound scratch assay and the artificial migration front assay, that can obtain quantitative and qualitative data, respectively, on the migratory performance of epithelial cells.

Effectiveness of the I2AO2 interdisciplinary programme led by nurses on metabolic syndrome and cardiovascular risk: a randomized, controlled trial

Objective To evaluate the effectiveness of an interdisciplinary programme led by nurses in relation to metabolic syndrome (MS) and cardiovascular risk (CVR). Methods This randomized, controlled, clinical trial included 74 patients diagnosed with MS (experimental group [EG], n = 37; control group [CG], n = 37). The intervention consisted of a 12-month interdisciplinary programme (pre-test, 6 months of intervention, 12 months of intervention, and 1-year follow-up post-intervention) coordinated by nursing. Results We found a progressive and significant reduction for all clinical, biochemical, and anthropometric parameters analysed at different time points. In the EG, remission of MS by 48.1% in the short term was observed (83.8% in the medium term) and maintained at 1 year post-intervention. In the CG, the prevalence of MS increased by 2.7% from the initial evaluation to study completion. A similar trend was observed for CVR. In the EG, 100% of subjects had a moderate-low risk of CVR at 1 year post-intervention, whereas the CG had CVR in all categories. Conclusion An interdisciplinary, nurse-led programme improves participants’ metabolic and cardiovascular health, while maintaining long-term effects. Our findings suggest an important role of the professional nurse as a nexus between the patient, different professionals, and the community.

Impact of the I 2 AO 2 interdisciplinary program led by nursing on psychological comorbidity and quality of life: Randomized controlled clinical trial

Objective: Obesity is an entity of highly prevalent multifactorial origin with associated metabolic and psychological comorbidity, causing a negative impact on the quality of life of those who suffer from it. The objective is to evaluate the impact of an interdisciplinary program for nurse‐led obesity on quality of life related to health and anxiety. Methods: Randomized controlled clinical trial with a sample of 74 subjects diagnosed with obesity (EG: n = 37; CG: n = 37). The intervention consisted of a 12‐month interdisciplinary program (with pre‐test, 12 month and 24 month follow‐up) coordinated by nurses. Results: The anxiety analysis shows that there is no effect of the intervention on S‐STAI (F2; 144 = 0.246; p = 0.782), which has increased in both groups. However, there is an effect on T‐STAI (F2; 144 = 8872; p < 0.001), which only increases in the control group. The interdisciplinary program has significantly improved health‐related quality of life (SF‐36), both in physical health parameters as well as in mental health. Conclusion: The interdisciplinary program led by nursing professionals has improved the quality of life related to health and has prevented the increase of anxiety‐trait in participants, maintaining the long‐term effects.

Uso e influência dos Planos de Parto e Nascimento no processo de parto humanizado

520 Objetivos: conhecer, analisar e descrever a situacao atual dos Planos de Parto e Nascimento no contexto estudado, comparando o processo de parto e sua finalizacao entre as mulheres que apresentaram e as que nao apresentaram um Plano de Parto e Nascimento. Metodo: estudo de coorte quantitativo, transversal, observacional descritivo comparativo, realizado durante um bienio. Foram selecionadas todas as mulheres que deram a luz no periodo estudado, incluindo 9303 mulheres. Resultados: o numero de Planos de Parto e Nascimento apresentados no primeiro ano foi de 132, contra 108 no segundo. Entre as variaveis analisadas, foi encontrada uma diferenca significativa para “contato pele a pele”, “eleicao de posicao de dilatacao e parto”, “uso de enema”, “ingestao de alimentos ou liquidos”, “partos normais”, “clampeamento tardio do cordao” e “depilacao do perineo”. Conclusoes: os Planos de Parto y Nascimento influenciam positivamente o processo de parto e sua finalizacao. Sao necessarias politicas sanitarias para aumentar o numero de Planos de Parto e Nascimento apresentados nos hospitais estudados.

Uso e influencia de los Planes de Parto y Nacimiento en el proceso de parto humanizado

520 Objetivos: conhecer, analisar e descrever a situacao atual dos Planos de Parto e Nascimento no contexto estudado, comparando o processo de parto e sua finalizacao entre as mulheres que apresentaram e as que nao apresentaram um Plano de Parto e Nascimento. Metodo: estudo de coorte quantitativo, transversal, observacional descritivo comparativo, realizado durante um bienio. Foram selecionadas todas as mulheres que deram a luz no periodo estudado, incluindo 9303 mulheres. Resultados: o numero de Planos de Parto e Nascimento apresentados no primeiro ano foi de 132, contra 108 no segundo. Entre as variaveis analisadas, foi encontrada uma diferenca significativa para “contato pele a pele”, “eleicao de posicao de dilatacao e parto”, “uso de enema”, “ingestao de alimentos ou liquidos”, “partos normais”, “clampeamento tardio do cordao” e “depilacao do perineo”. Conclusoes: os Planos de Parto y Nascimento influenciam positivamente o processo de parto e sua finalizacao. Sao necessarias politicas sanitarias para aumentar o numero de Planos de Parto e Nascimento apresentados nos hospitais estudados.

Cuidados enfermeros a pacientes intervenidos mediante cirugía radiológica. Caso clínico

We report the case of a 73-year-old man with medical diagnoses of long-standing diabetes mellitus, chronic ischemia of the lower limbs and intermittent claudication, for which the patient had been treated with minimally invasive radiological surgery. On arrival at the radiology unit, the patient had nursing diagnoses of anxiety and fear. Intraoperatively, the client had nursing diagnoses of pain, urine retention and infection risk. At discharge, a collaboration problem was detected and hemorrhagic risk. The patient received individualized nursing care. Interventions were planned following the nursing intervention classification (NIC) and the expected results for these interventions followed the Nursing Outcomes Classification (NOC) taxonomy. The application of an appropriate nursing care plan contributes to making the patients hospital stay easier, more comfortable and less traumatic.Resumen Se presenta el caso clinico de un paciente varon de 73 anos, con los diagnosticos medicos de diabetes mellitus de larga evolucion, isquemia cronica de miembros inferiores y claudicacion intermitente, al que se le ha tratado con cirugia minimamente invasiva radiologica. A su llegada a la unidad de radiologia, el paciente presenta los diagnosticos enfermeros de ansiedad y temor; durante el intraoperatorio dolor, retencion urinaria y riesgo de infeccion, y al alta de la unidad se detecta el problema de colaboracion y el riesgo de hermorragia. Se le prestan cuidados enfermeros individualizados, y se planifican las intervenciones segun las clasificaciones NIC (Nursing Intervention Classification) y los resultados esperados de estas intervenciones segun la taxonomia NOC (Nursing Outcomes Classification). La aplicacion de un correcto plan de cuidados enfermeros ayuda a que la estancia del paciente en el quirofano sea mas facil, confortable y menos traumatica.