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Satisfaccion de la calidad del cuidado de enfermeria pre-intraoperatorio en pacientes intervenidos a cirugia de mama , Instituto Nacional de Enfermedades Neoplasicas
No full textThe essence of nursing is patient care, having as a fundamental axis in the processes of quality care; however, sometimes due to the workload, reduced time in care, lack of protocols, training, staff attitudes, among other aspects; affect the quality of nursing care, which generates dissatisfaction in patient health care. Objective: To determine the level of satisfaction with the quality of preoperative and intraoperative nursing care in patients undergoing breast surgery at the National Institute of Neoplastic Diseases, 2020. Method: Quantitative, descriptive, cross-sectional, prospective. The population consisted of 664 patients undergoing breast surgery, the sample size was 191 patients by probabilistic, simple random sampling, the instrument used to collect the data was a questionnaire, validity was carried out through trial of 8 experts whose value was 0.030 and for reliability the Kuder Richardson test was applied whose value is 0.81 obtaining high reliability. Results: The level of satisfaction of the quality of preoperative and intraoperative nursing care 59.16% of the patients undergoing breast surgery considered to be moderately satisfied with the nursing care received. Conclusions: Satisfaction with the quality of nursing care in the preoperative and intraoperative area is moderately satisfied and dissatisfied, so it is necessary to reinforce care actions that improve the perception of patients in the area
Association between nutritional status and dementia staging among Alzheimer’s disease patients in Peru: Preliminary results of the Genetic of Alzheimer’s Disease in Peruvian Population Study
No full textBackground: Alzheimer’s Disease Related Dementias (ADRD) is estimated to increase up to 152 million in 2050. Dementia-related mortality increases with older age, male sex, neuropsychiatric symptoms, faster cognitive decline, physical impairment and disease severity. Malnutrition is an important ADRD complication due to its impact on several domains. Prior studies showed that malnutrition is associated with behavioral and cognitive impairment (emotional disinhibition and behavior disturbance, memory impairment) and higher mortality risk among ADRD patients. Prevalence of malnutrition is heterogeneous and may depend on disease severity. We aimed to assess the association between malnutrition and dementia severity in an outpatient cohort of Peruvians, part of the Genetic of Alzheimer’s Disease in Peruvian Population (GAPP) Study. Method: A cross-sectional study was carried out in three different sites of different altitude in Peru. We included individuals aged >50 years who attended memory clinics. We used the Mini-Nutritional Assessment (MNA) scale to assess the nutritional status, and the Clinical Dementia Rating (CDR) to grade the dementia. We stratified the nutritional status in normal (MNA score: 12-14) and malnourished or risk of malnourished (MNA: 11 or less). Result: We assessed 295 patients mean age was 71.9 (SD: 8.3) and 68.8% were females proportion of demented (CDR> = 1) was 23%. Prevalence of malnourishment and risk of malnourishment was 6.4% and 35%, respectively. When adjusted by demographic covariates and geographical recruitment site, we found malnourishment scores significantly associated with CDR scores (e.g. CDR 2-3: PR 2.27, 95% CI: 1.95-2.62). Malnourishment was not associated with cardiovascular risk factors or diseases. Conclusion: In our Peruvian cohort, malnourishment or risk of malnourishment was found associated with higher risk of ADRD. Prevalence of malnourishment or risk of malnourishment was in line with those reported in other South American countries. Further longitudinal studies should confirm this association
Outcomes of HTLV-1 Carriers with Diffuse Large B-Cell Lymphoma: A Single-Center Retrospective Matched Cohort Study
No full textBackground: The human T-cell lymphotropic virus type 1 (HTLV-1) is associated with aggressive diseases, such as adult T-cell leukemia/lymphoma (ATLL). However, less is known on the impact of HTLV-1 infection in non-ATLL hematologic malignancies. We aimed to investigate if HTLV-1 carriers with diffuse large B-cell lymphoma (DLBCL) have worse survival outcomes than non-HTLV-1 carriers. Materials and Methods: We performed a single-center retrospective cohort study by matching HTLV-1 carriers to non-carriers based on age, sex, Ann Arbor stage, and year of diagnosis. Our outcomes of interest were overall survival (OS) and progression-free survival (PFS). The Kaplan-Meier method was used to estimate OS and PFS between carriers and non-carriers. We fitted multivariate Cox regression models to assess the mortality and recurrence/disease progression risk of HTLV-1 infection. Results: A total of 188 patients, 66 with HTLV-1 infection and 122 without HTLV-1, were included in the study. HTLV-1 carriers had higher extranodal involvement than non-carriers (47% vs. 27%, P = .010). With a median follow-up of 78 months (95% CI: 41-90 months), HTLV-1 carriers had a similar 5 year OS (41% vs. 42%, P = .940) and PFS (34% vs. 32%, P = .691) compared to non-carriers. In the multivariate Cox analysis, HTLV-1 infection was not associated with worse OS (aHR: 0.98, 95% CI: 0.64-1.50) or PFS (aHR: 0.90, 95% CI: 0.60-1.34). Conclusion: HTLV-1 carriers with DLBCL did not have worse survival outcomes compared to non-carriers. Our results suggest that clinicians should follow standard guidelines for DLBCL management on HTLV-1 seropositive patients
Fagofobia Como Síntoma Inicial de Demencia Frontotemporal: Reporte de Caso
No full textIntroduction: Frontotemporal dementia is an important cause of dementia, and its diagnosis is complex due to the multiple neurocognitive manifestations that patients present. Eating disorders associated with this pathology have been reported, but phagophobia is an atypical manifestation. Case report: We present the case of a 74-year-old adult patient with onset of phagophobia associated with a progressive and significant loss of executive functions, compromised spatial orientation, presenting in parallel a marked compromise in instrumental daily activities, psychotic symptoms, apathy, gait disturbance and sleep problems. Conclusions: It is important that adult and older patients with eating disorders, particularly those who also present cognitive, behavioural and social dysfunction are evaluated to rule out the broad spectrum of frontotemporal dementia, since timely diagnosis and treatment can improve quality of life or slow its progression
Estrategias de Afrontamiento que usan los profesionales de enfermeria para evitar el sindrome de Burnout
No full textObjectives: To determine the coping strategy applied by nurses to avoid Burnout syndrome in the 5th and 6th East Surgery Services of the National Institute of Neoplastic Diseases. Methodology: This was a quantitative, descriptive, non-experimental, cross-sectional study. The population consisted of 50 nursing professionals. The cope questionnaire was used to identify coping strategies. The results showed that the majority of nurses used: coping focused on the problem, followed by emotion and the lowest percentage was focused on cognitive avoidance. It is concluded that nurses in their work environment must constantly use strategies that allow them to avoid emotional exhaustion. Likewise, soft skills training, as well as self-care activities are preventive actions that allow them to feel well
Factores mecánicos y químicos presentes en pacientes oncológicos hospitalizados con flebitis
No full textObjetivo: Identificar los factores mecánicos y químicos presentes en pacientes oncológicos con flebitis, hospitalizados en un establecimiento público de alta complejidad, Lima-Perú; describir las técnicas invasivas más frecuentes practicadas en los procesos de hospitalización y las tendencias de los últimos 5 años. Material y Método: Enfoque cuantitativo, observacional, retrospectivo, con una población total de 295.151 (del 2016-2020), de los que 298 pacientes oncológicos tuvieron flebitis, pero solo 282 contaron con registros completos valorados por las enfermeras oncólogas según Escala de Maddox que consta de 16 ítems que miden factores mecánicos y químicos. El instrumento fue validado por expertos obteniéndose una validez binomial de 0,7 y una confiabilidad KR20 de 0,8. El análisis de datos se realizó mediante estadística descriptiva, prueba binomial y Chi cuadrado. Resultados: Estos muestran la mayor incidencia en los grados de flebitis II, III y I. Respecto al factor mecánico, se evidencia que el material no estéril, el lugar de inserción del catéter en zona Cubital, Radial y Cefálica y el tiempo de permanencia menor de 72 h se presentan con mayor frecuencia. El factor químico está asociado al uso de antibióticos como Vancomicina y la combinación del Meropenem/ Vancomicina, al uso de agentes citostáticos vesicantes-no vesicantes, así también el analgésico Ketoprofeno seguido con la combinación del Ketoprofeno con Tramadol y al uso de la Ranitidina como protector antiulceroso. Conclusión: Tanto los factores mecánicos y químicos afectan la zona de punción. Enfermería debe continuar capacitando en acciones preventivas para reducir o mitigar las complicaciones en el ámbito asistencial, siendo necesario promover buenas prácticas en la administración terapéutica en este tipo de paciente
Scientific evidence on mental health in nursing professionals in the hospital setting
No full textNowadays, given the pandemic situation caused by COVID 19, it has become clear that health personnel are at high risk of presenting emotional problems due to the uncertainty of the potential risks of the hospital environment. Objective: To determine the scientific evidence on mental health in nursing professionals in the hospital context. Method: Integrative, exploratory review in 2 databases, Dialnet and Google Scholar, considering the inclusion criteria as English, Spanish and Portuguese. Results. There is evidence of an increase in the presence of mental health problems in nurses, such as stress, anxiety, depression, fear, among others. In the face of unknown highly contagious illnesses that have appeared in recent years, which places them at high occupational risk and affects the quality of life of the professionals responsible for care. It is concluded that, in the face of the health emergency, nurses should use biosecurity and personal protection measures in health practice, such as taking care of their mental health, in order to maintain an adequate relationship involving patient-nurse care. It also favours timely preventive interventions in the mental health care of nurses
Primary central nervous system sarcoma with DICER1 mutation—treatment results of a novel molecular entity in pediatric Peruvian patients
No full textBackground: A high frequency of primary central nervous system (CNS) sarcomas was observed in Peru. This article describes the clinical characteristics, biological characteristics, and outcome of 70 pediatric patients. Methods: Data from 70 pediatric patients with primary CNS sarcomas diagnosed between January 2005 and June 2018 were analyzed. DNA methylation profiling from 28 tumors and gene panel sequencing from 27 tumors were available. Results: The median age of the patients was 6 years (range, 2-17.5 years), and 66 of 70 patients had supratentorial tumors. DNA methylation profiling classified 28 of 28 tumors as primary CNS sarcoma, DICER1 mutant. DICER1 mutations were found in 26 of 27 cases, TP53 mutations were found in 22 of 27 cases, and RAS-pathway gene mutations (NF1, KRAS, and NRAS) were found in 19 of 27 tumors, all of which were somatic (germline control available in 19 cases). The estimated incidence in Peru was 0.19 cases per 100,000 children (<18 years old) per year, which is significantly higher than the estimated incidence in Germany (0.007 cases per 100,000 children [<18 years] per year P <.001). Patients with nonmetastatic disease (n = 46) that were treated with a combination therapy had a 2-year progression-free survival (PFS) rate of 58% (95% CI, 44%-76%) and a 2-year overall survival rate of 71% (95% CI, 57%-87%). PFS was the highest in patients treated with chemotherapy with ifosfamide, carboplatin, and etoposide (ICE) after upfront surgery followed by radiotherapy and ICE (2-year PFS, 79% [59%-100%], n = 18). Conclusions: Primary CNS sarcoma with DICER1 mutation has an aggressive clinical course. A combination of surgery, chemotherapy, and radiotherapy seems beneficial. An underlying cancer predisposition syndrome explaining the increased incidence in Peruvian patients has not been identified so far. Lay Summary: A high incidence of primary pediatric central nervous system sarcomas in the Peruvian population is described. Using sequencing technologies and DNA methylation profiling, it is confirmed that these tumors molecularly belong to the recently proposed entity “primary central nervous system sarcomas, DICER1 mutant.” Unexpectedly, DICER1 mutations as well as all other defining tumor mutations (TP53 mutations and RAS-pathway mutations) were not inherited in all 19 patients where analyzation was possible. These tumors have an aggressive clinical course. Multimodal combination therapy based on surgery, ifosfamide, carboplatin, and etoposide chemotherapy, and local radiotherapy leads to superior outcomes
Navegador de Enfermeria para el cuidado y manejo en pacientes Oncologicos
No full textObjective: To analyze the development of scientific evidence on the use of the nurse navigator for the care and management of oncology patients. Materials and method: An integrative review was conducted in the databases PubMed, Science Direct Cochrane Library and Scielo of publications generated between 2011 and 2021, using the key descriptors "navigator", "nurse" "oncology" "cancer" and their respective synonyms in English and Spanish". Results: Scientific evidence highlights the need for the use of nurse navigators to promote educational actions for the management and health care of continuing and new oncology patients with the aim of sustaining self-care during the disease process. Conclusions: It is important to implement this platform in health services as a strategy of technological innovation in continuity of care, in order to avoid risk of complications in their health and to be addressed in a timely manner, to be referred to competent personnel as appropriate
Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study
No full textObjectives Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. Design A multicentre, international, collaborative cohort study. Setting 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. Participants Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. Main outcome measure All-cause mortality at 30 days and 90 days. Results 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). Conclusions The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally