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Pérez-Rugosa V, de Lorena-Quintal P, Domínguez-Valdés E, Rodríguez-Rodríguez A, Núñez-Castro I, Suárez-Fernández Y, Sarabia-Cobo C. Exploring older people's experiences of the interpersonal care relationship between nurses and patients during hospitalization in the pandemic period: A qualitative study. J Adv Nurs 2024. [PMID: 38225866 DOI: 10.1111/jan.16050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/17/2024]
Abstract
AIM This article presents the findings of a qualitative study focusing on the experiences of people aged over 70 years in the interpersonal nurse-patient care relationship in hospital settings during and after the COVID-19 pandemic. The aim was to analyse different aspects of this relationship, including nurses' behaviour and caring attitudes, the person-centred model of care, patients' involvement in their own care and communication in the hospital context. DESIGN An exploratory qualitative study was conducted on the basis of an interpretative framework. METHODS Six focus groups were conducted. A total of 34 participants were purposively recruited from three nursing homes in Spain, Italy and Portugal. Specific inclusion criteria were used to select participants. RESULTS Five main categories were identified. Analysis revealed the importance of empathy and sensitivity in caring relationships, as well as the need for personalized and patient-centred care. The importance of effective communication and recognition of ageist behaviour by professionals was highlighted. In addition, independent of the pandemic, situational factors in the hospital environment were identified that influence the interpersonal care relationship. CONCLUSIONS The study highlights the need to promote a person-centred model of care that takes into account the specific preferences and needs of older people. This is achieved by identifying elements of the interpersonal nurse-patient relationship. In addition to highlighting the disparity of opinion regarding an active or passive role in self-care and decision making, the importance of addressing ageism and improving communication is emphasized. WHAT PROBLEM DID THE STUDY ADDRESS?: The importance of the patient-nurse relationship in hospital care has been highlighted in previous studies. Critical elements of the patient care experience have been identified as empathy and effective communication. Ageism in healthcare has been recognized as a potential barrier to patient-centred care. WHAT WERE THE KEY FINDINGS?: The main findings highlight the importance of empathy and personalized care, emphasize the importance of effective communication and address ageist behaviours in the nurse-patient relationship. WHERE AND WHO WILL THE RESEARCH IMPACT?: By highlighting the need for person-centred care and improved communication strategies, particularly in the context of caring for older patients during and after the COVID-19 pandemic, this research will have an impact on healthcare professionals, policy makers and carers. REPORTING METHOD The COREQ guideline was used. PATIENT OR PUBLIC CONTRIBUTION This study adopted a collaborative approach to ensure that patient perspectives were integrated into the research process. We organized regular focus groups. Patients were actively involved in shaping the research questions, refining the study design and interpreting the emerging findings. Their valuable input helped us to understand the nuances of their experience and to prioritize the aspects that were critical to their well-being. In addition, their insights guided the development of practical recommendations aimed at improving the interpersonal care relationship between nurses and patients in hospital settings, ensuring that their voices were heard and reflected in the proposed interventions. This patient-centred approach fostered a sense of empowerment among the participants. It reinforced the notion that their experiences and opinions are integral to shaping healthcare practice.
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Affiliation(s)
| | | | | | | | | | | | - Carmen Sarabia-Cobo
- Faculty of Nursing, University of Cantabria, Santander, Spain
- Nursing Research Group, IDIVAL. CIBERFRAIL, Santander, Spain
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Vargas-Morales J, Boer-Pérez F, Cossío-Torres P, De La Cruz-Maldonado M, Hernandez-Morales P, Rodríguez-Rodríguez A, Jurado-Manzano B. W199 Association of cardiometabolic risk biomarkers with waist-height index in children and adolescents from San Luis Potosí, México. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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3
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Sempere L, Rodríguez-Rodríguez A, Boyero L, Egea-Guerrero J. Principales modelos experimentales de traumatismo craneoencefálico: de la preclínica a los modelos in vitro. Med Intensiva 2019; 43:362-372. [DOI: 10.1016/j.medin.2018.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 02/08/2023]
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4
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Garcia-Gasalla M, Arrizabalaga-Asenjo M, Collado-Giner C, Ventayol-Aguiló L, Socias-Mir A, Rodríguez-Rodríguez A, Pérez-Seco MC, Payeras-Cifré A. Results of a multi-faceted educational intervention to prevent peripheral venous catheter-associated bloodstream infections. J Hosp Infect 2019; 102:449-453. [PMID: 30771370 DOI: 10.1016/j.jhin.2019.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 02/06/2019] [Indexed: 11/18/2022]
Abstract
Peripheral venous catheter-associated bloodstream infections (PVC-BSIs) lead to prolonged hospitalization, morbidity and increased costs. The impact of infection-prevention measures on the rate of PVC-BSIs in a university hospital in Spain was assessed. An active surveillance programme was initiated in 2015, which revealed a high PVC-BSI incidence ratio (0.48/1000 patient-days). A bundle aimed at nurses, medical staff and patients was implemented, and a Catheter Infection Team (CIT) was set up. The intervention achieved a decrease in PVC-BSI rate: 0.34 in 2016, 0.29 in 2017, and 0.17 in 2018. The decline was greatest for Gram-negative PVC-BSIs (67.6% in 2015, 35.3% in 2018).
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Affiliation(s)
- M Garcia-Gasalla
- Infectious Diseases Unit/Internal Medicine Department, Hospital Son Llátzer, Palma de Mallorca, Baleares, Spain.
| | - M Arrizabalaga-Asenjo
- Infectious Diseases Unit/Internal Medicine Department, Hospital Son Llátzer, Palma de Mallorca, Baleares, Spain
| | - C Collado-Giner
- Infectious Diseases Unit/Internal Medicine Department, Hospital Son Llátzer, Palma de Mallorca, Baleares, Spain
| | - L Ventayol-Aguiló
- Internal Medicine Department, Hospital Universitari Son Llàtzer, Palma de Mallorca, Baleares, Spain
| | - A Socias-Mir
- Intensive Care Unit, Hospital Universitari Son Llàtzer, Palma de Mallorca, Baleares, Spain
| | - A Rodríguez-Rodríguez
- Unidad de Investigación, Apoyo Metodológico y Estadístic, Fundació Institut d'Investigació Sanitària Illes Balears - IdISBa, Hospital Universitari Son Llàtzer, Palma de Mallorca, Baleares, Spain
| | - M-C Pérez-Seco
- Microbiology Dept. Hospital Universitari Son Llàtzer, Palma de Mallorca, Baleares, Spain
| | - A Payeras-Cifré
- Infectious Diseases Unit/Internal Medicine Department, Hospital Son Llátzer, Palma de Mallorca, Baleares, Spain
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Naranjo-Izurieta JR, Ruiz de Azúa-López Z, Lameirao J, Martín-Villén L, Roldán-Reina A, Porras-López M, Rodríguez-Rodríguez A, Egea-Guerrero JJ. Orthotopic Liver Transplantation: Preliminary Analysis of Complications With Grafts From Elderly Donors. Transplant Proc 2018; 50:644-645. [PMID: 29579876 DOI: 10.1016/j.transproceed.2017.12.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study aims to determine if donor grafts of patients older than 65 years develop more post-transplantation complications than those of younger patients. DESIGN This is a retrospective, observational study of liver transplant recipients during 12 months in Virgen del Rocio University Hospital. We compare incidence rates of reperfusion syndrome, acute kidney injury, and need for intra- and postoperative red blood cell transfusions in two donor age groups in which group A is <65 years old and group B is ≥65 years old. RESULTS Sixty cases were included. Reperfusion syndrome, acute kidney injury, and both intra- and postoperative red blood cell transfusion were more frequent in group A than group B (11.4% vs. 4%, P = .390; 44% vs. 32%, P = .423; 68.8% vs. 48%, P = .120; and 70.6% vs. 64%, P = .779, respectively). Six recipients (17.1%) died at 12 months from group A whereas there were no deaths register in group B during that time (P = .036). CONCLUSION Our results showed that including elderly donors does not aggravate incidence of complications, emphasizing that advanced age should not be an exclusion criteria for liver transplantation.
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Affiliation(s)
- J R Naranjo-Izurieta
- Management Unit of Critical Care, University Hospital Virgen del Rocío, Seville, Spain.
| | - Z Ruiz de Azúa-López
- Management Unit of Critical Care, University Hospital Virgen del Rocío, Seville, Spain; Intrahospital Transplant Coordination, University Hospital Virgen del Rocío, Seville, Spain
| | - J Lameirao
- Management Unit of Critical Care, University Hospital Virgen del Rocío, Seville, Spain
| | - L Martín-Villén
- Management Unit of Critical Care, University Hospital Virgen del Rocío, Seville, Spain; Intrahospital Transplant Coordination, University Hospital Virgen del Rocío, Seville, Spain
| | - A Roldán-Reina
- Management Unit of Critical Care, University Hospital Virgen del Rocío, Seville, Spain
| | - M Porras-López
- Management Unit of Critical Care, University Hospital Virgen del Rocío, Seville, Spain
| | - A Rodríguez-Rodríguez
- Management Unit of Critical Care, University Hospital Virgen del Rocío, Seville, Spain
| | - J J Egea-Guerrero
- Management Unit of Critical Care, University Hospital Virgen del Rocío, Seville, Spain; Sectorial Coordination of Transplants, Sevilla-Huelva, Sevilla, Spain
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Muñoz-Sánchez MÁ, Rodríguez-Rodríguez A, Egea-Guerrero JJ, Gordillo-Escobar E, Vilches-Arenas Á, Carrillo-Vico A, Guerrero JM, Murillo-Cabezas F. Urotensinergic system genes in experimental subarachnoid hemorrhage. Med Intensiva 2017; 41:468-474. [PMID: 28081921 DOI: 10.1016/j.medin.2016.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/14/2016] [Accepted: 10/23/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Cerebral vasospasm, one of the main complications of subarachnoid hemorrhage (SAH), is characterized by arterial constriction and mainly occurs from day 4 until the second week after the event. Urotensin-II (U-II) has been described as the most potent vasoconstrictor peptide in mammals. An analysis is made of the serum U-II concentrations and mRNA expression levels of U-II, urotensin related peptide (URP) and urotensin receptor (UT) genes in an experimental murine model of SAH. DESIGN An experimental study was carried out. SETTING Experimental operating room of the Biomedicine Institute of Seville (IBiS), Virgen del Rocío University Hospital (Seville, Spain). PARTICIPANTS 96 Wistar rats: 74 SAH and 22 sham intervention animals. INTERVENTIONS Day 1: blood sampling, followed by the percutaneous injection of 100μl saline (sham) or blood (SAH) into the subarachnoid space. Day 5: blood sampling, followed by sacrifice of the animals. MAIN VARIABLES OF INTEREST Weight, early mortality, serum U-II levels, mRNA values for U-II, URP and UT. RESULTS Serum U-II levels increased in the SAH group from day 1 (0.62pg/mL [IQR 0.36-1.08]) to day 5 (0.74pg/mL [IQR 0.39-1.43]) (p<0.05), though not in the sham group (0.56pg/mL [IQR 0.06-0.83] day 1; 0.37pg/mL [IQR 0.23-0.62] day 5; p=0.959). Between-group differences were found on day 5 (p<0.05). The ROC analysis showed that the day 5 serum U-II levels (AUC=0.691), URP mRNA (AUC=0.706) and UT mRNA (AUC=0.713) could discriminate between sham and SAH rats. The normal serum U-II concentration range in rats was 0.56pg/mL (IQR 0.06-0.83). CONCLUSION The urotensinergic system is upregulated on day 5 in an experimental model of SAH.
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MESH Headings
- Animals
- Biomarkers
- Disease Models, Animal
- Gene Expression Regulation
- Peptide Hormones/biosynthesis
- Peptide Hormones/blood
- Peptide Hormones/genetics
- RNA, Messenger/biosynthesis
- RNA, Messenger/blood
- RNA, Messenger/genetics
- ROC Curve
- Rats
- Rats, Wistar
- Real-Time Polymerase Chain Reaction
- Receptors, G-Protein-Coupled/biosynthesis
- Receptors, G-Protein-Coupled/blood
- Receptors, G-Protein-Coupled/genetics
- Sensitivity and Specificity
- Subarachnoid Hemorrhage/complications
- Subarachnoid Hemorrhage/genetics
- Urotensins/biosynthesis
- Urotensins/blood
- Urotensins/genetics
- Vasoconstriction/genetics
- Vasospasm, Intracranial/etiology
- Vasospasm, Intracranial/genetics
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Affiliation(s)
- M Á Muñoz-Sánchez
- Servicio de Urgencias, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
| | - A Rodríguez-Rodríguez
- Cuidados Críticos, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain.
| | - J J Egea-Guerrero
- Cuidados Críticos, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
| | - E Gordillo-Escobar
- Cuidados Críticos, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
| | - Á Vilches-Arenas
- Servicio de Medicina Preventiva y Salud Pública, Hospital Virgen Macarena, Universidad de Sevilla, Spain
| | - A Carrillo-Vico
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Spain; Departamento de Bioquimica Médica, Biología molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Spain
| | - J M Guerrero
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Spain; Departamento de Bioquimica Médica, Biología molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Spain
| | - F Murillo-Cabezas
- Cuidados Críticos, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
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Egea-Guerrero JJ, Rodríguez-Rodríguez A. Sepsis biomarkers in severe burn patients: Cut-off point or time profile? Med Intensiva 2016; 40:595-596. [PMID: 27267774 DOI: 10.1016/j.medin.2016.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 04/04/2016] [Indexed: 11/17/2022]
Affiliation(s)
- J J Egea-Guerrero
- U.G.C. Cuidados Críticos y Urgencias, H.U. Virgen del Rocío, IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain.
| | - A Rodríguez-Rodríguez
- U.G.C. Cuidados Críticos y Urgencias, H.U. Virgen del Rocío, IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain
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8
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Hernández-García C, Rodríguez-Rodríguez A, Egea-Guerrero J. Brain injury biomarkers in the setting of cardiac surgery: Still a world to explore. Brain Inj 2015; 30:10-7. [DOI: 10.3109/02699052.2015.1079733] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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9
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Egea-Guerrero JJ, Revuelto-Rey J, Gordillo-Escobar E, Rodríguez-Rodríguez A, Enamorado-Enamorado J, Ruiz de Azúa López Z, Aldabó-Pallás T, León-Justel A, Murillo-Cabezas F, Vilches-Arenas A. Serologic behavior of S100B protein in patients who are brain dead: preliminary results. Transplant Proc 2014; 45:3569-72. [PMID: 24314961 DOI: 10.1016/j.transproceed.2013.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study is to assess the S100B protein serum concentrations from brain dead (BD) donors to understand whether its level could provide clinical information during BD diagnosis as a potential confirmatory test. METHODS During 12 months, 26 patients declared BD were prospectively included in this study. Once the diagnosis of BD was achieved, serum S100B protein levels were measured using an electrochemiluminescence assay. For analytical purposes, we selected the maximum S100B serum value reached during the first 5 days of evolution from a historical cohort of 124 survived patients after a severe brain injury (SBI), as well as from 18 healthy donors (HD) and a subgroup of patients who had severe traumatic brain injuries (TBIs) without extracranial injuries. RESULTS Mean age was 53.48 years (SD, 18.91 years). The BD group had significantly higher S100B serum levels (1.44 μg/L; interquartile ratio [IR], 0.63-3.68) than the SBI (0.34 μg/L; IR, 0.21-0.60) and HD groups (0.06 μg/L; IR, 0.03-0.07; P < .001). Analysis of S100B levels depending on the main cause responsible for BD development showed significant differences between subgroups (P = .012). S100B serum levels were higher in the isolated TBI BD group (P = .004). The S100B value showed an odds ratio for BD diagnosis of 8.38 (95% confidence interval [CI], 1.16-60.45; P = .035). Reciever operating characteristic analysis revealed an area under the curve of 0.92 (95% CI, 0.79-1.00; P = .007). We set a cut-off value of 2 μg/L in S100B serum concentrations. At this level, the diagnostic properties of S100B would reach 100% of specificity and positive predictive value (PPV), and sensitivity and negative predictive value (NPV) of 60% and 86.7%, respectively. CONCLUSION This preliminary analysis shows for the very first time that BD is associated with higher S100B serum levels, compared with other neurocritical care patients. We also found that the cause of BD development must be considered. Specifically, S100B serum levels in severe isolated TBI patients-with clinical exploration compatible with BD-could be used in a future as confirmatory test.
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Affiliation(s)
- J J Egea-Guerrero
- NeuroCritical Care Unit, Virgen del Rocío University Hospital, IBIS/CSIC/University of Seville, Spain.
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10
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Egea-Guerrero JJ, Murillo-Cabezas F, Rodríguez-Rodríguez A, Gordillo-Escobar E, Revuelto-Rey J, Muñoz-Sánchez MA, León-Justel A, Vilches-Arenas A. [An experimental model of mass-type brain damage in the rat: expression of brain damage based on neurospecific enolase and protein S100B]. Med Intensiva 2013; 38:218-25. [PMID: 23786666 DOI: 10.1016/j.medin.2013.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 03/14/2013] [Accepted: 03/31/2013] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To determine whether a model of transient mass-type brain damage (MTBD) in the rat produces early release of neurospecific enolase (NSE) and protein S100B in peripheral blood, as an expression of the induced brain injury. DESIGN An experimental study with a control group. SETTING Experimental operating room of the Institute of Biomedicine (IBiS) of Virgen del Rocío University Hospital (Seville, Spain). PARTICIPANTS Fourteen adult Wistar rats. INTERVENTIONS Blood was sampled at baseline, followed by: MTBD group, a trephine perforation was used to insert and inflate the balloon of a catheter at a rate of 500 μl/20 sec, followed by 4 blood extractions every 20 min. Control group, the same procedure as before was carried out, though without trephine perforation. PRIMARY STUDY VARIABLES Weight, early mortality, serum NSE and S100B concentration. RESULTS Differences in NSE and S100B concentration were observed over time within the MTBD group (P<.001), though not so in the control group. With the exception of the baseline determination, differences were observed between the two groups in terms of the mean NSE and S100B values. Following MTBD, NSE and S100B progressively increased at all measurement timepoints, with r=0.765; P=.001 and r=0.628; P=.001, respectively. In contrast, the control group showed no such correlation for either biomarker. CONCLUSIONS Serum NSE and S100B concentrations offer an early indication of brain injury affecting the gray and white matter in an experimental model of mass-type MTBD in the rat.
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Affiliation(s)
- J J Egea-Guerrero
- Unidad de Neurocríticos, H.U. Virgen del Rocío, IBiS/CSIC Universidad de Sevilla, Sevilla, España.
| | - F Murillo-Cabezas
- Unidad de Neurocríticos, H.U. Virgen del Rocío, IBiS/CSIC Universidad de Sevilla, Sevilla, España
| | - A Rodríguez-Rodríguez
- Departamento de Bioquímica Clínica, H.U. Virgen del Rocío, IBiS/CSIC Universidad de Sevilla, Sevilla, España
| | - E Gordillo-Escobar
- Unidad de Neurocríticos, H.U. Virgen del Rocío, IBiS/CSIC Universidad de Sevilla, Sevilla, España
| | - J Revuelto-Rey
- Unidad de Neurocríticos, H.U. Virgen del Rocío, IBiS/CSIC Universidad de Sevilla, Sevilla, España
| | - M A Muñoz-Sánchez
- Unidad de Neurocríticos, H.U. Virgen del Rocío, IBiS/CSIC Universidad de Sevilla, Sevilla, España
| | - A León-Justel
- Departamento de Bioquímica Clínica, H.U. Virgen del Rocío, IBiS/CSIC Universidad de Sevilla, Sevilla, España
| | - A Vilches-Arenas
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, IBiS/CSIC Universidad de Sevilla, Sevilla, España
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Rodríguez-Gómez D, Rodríguez-Rodríguez A, Pérez-Carral O, Lustres-Pérez M, Cid-Rodríguez MC. [Chronic demyelinating polyneuropathy secondary to treatment with tacrolimus]. Rev Neurol 2008; 46:189-190. [PMID: 18297634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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12
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Rodríguez-Rodríguez A, Naves M, Rodríguez-Rebollar A, Gómez C, Braga S, Cannata-Andía JB. Hormonal replacement therapy in an animal model with chronic renal failure and ovariectomy: biochemical and densitometric study. Kidney Int Suppl 2003:S57-61. [PMID: 12753267 DOI: 10.1046/j.1523-1755.63.s85.14.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In spite of estrogen replacement therapy being extensively used in clinical and experimental studies without renal impairment, there are no long-term studies concerning estrogen replacement in chronic renal failure. METHODS In this experimental study, six groups of nephrectomized and ovariectomized animals were treated with different doses of 17beta-estradiol, alone or in combination with calcitriol, to evaluate the effect of these treatments on bone metabolism. RESULTS Biochemical results showed that estrogen alone did not have any effect neither on calcium nor on PTH serum levels. By contrast, in the groups treated with calcitriol, the levels of serum calcium were significantly higher, and the levels of iPTH were significantly lower than those observed in the control group. Animals receiving the combined treatment with estrogen and calcitriol showed the greater gain in uterus weight and a better bone mineral density at the lumbar site and the proximal and distal tibia sites. CONCLUSION The combination of estrogen and calcitriol is the most effective therapy to prevent bone mass loss in animals with chronic renal failure and estrogen deprivation.
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Affiliation(s)
- A Rodríguez-Rodríguez
- Servicio de Metabolismo Oseo y Mineral, Instituto Reina Sofía de Investigación; and Servicio de Bioquímica I.N.S. Hospital Universitario Central de Asturias, Oviedo, España
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13
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Rama-Maceiras P, Duro J, Figueira-Moure A, Rey-Rilo T, Toral A, Rodríguez-Rodríguez A. [Ventilation in prone decubitus in a patient with respiratory distress during heart surgery]. Rev Esp Anestesiol Reanim 1999; 46:81-4. [PMID: 10100443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Acute respiratory failure and adult respiratory distress syndrome are serious complications after heart surgery and are associated with a high mortality rate. We report the case of a 50-year-old man who developed severe respiratory distress after heart surgery with extracorporeal circulation and for whom oxygenation was possible with ventilation in prone decubitus position only after other therapeutic measured had failed. The physiological bases of ventilation in prone decubitus position, as well as the indications and contraindications of the technique are discussed. Early treatment, which is fundamental for managing these patients, facilitates a favorable outcome as is illustrated by the case we report.
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Affiliation(s)
- P Rama-Maceiras
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Complejo Hospitalario Juan Canalejo, La Coruña
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14
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Encinar-Arias L, Rodríguez-Rodríguez A. [Suture of pulmonary artery catheter in heart surgery]. Rev Esp Anestesiol Reanim 1996; 43:187. [PMID: 8927784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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