NPunto

16

Authors: Mifsud Grau, L

Attend emergency in primary care is fundamental in the structure of the Spanish public health. They suppose to extend the hours of the many health centers so that the medical consultation is available 24 hours a day, 365 days per year. Thousands of patients are evaluated by phisicians every day at this place but studies in this area are scarce. Therefore, we consider that knowing how is the patient who comes to this kind of health center, as well as assessing their quality of life through the SF-36 questionnaire will allow us to know better our patients and progressively try to offer a better service.

22

Authors: Moya Crespo, M.J

Introduction: United States is experiencing an epidemic due to the misuse of opioids, and in Spain, in the last 20 years, there has also been an increase in the prescription of opioids, which increases the risk of poisoning. In addition, the presence of new synthetic opioids without medical authorization is exacerbating the problem. Up to one in four patients on long-term opioid medical treatment struggle with opioid addiction. Objective: To know the impact that the consumption of opioids has on people and analyze the management of acute opioid poisoning, as well as if there are ways to identify it ahead of time and prevent it, identifying the approach from Nursing. Methodology: A total of 56 documents, in English and Spanish, have been selected to carry out this bibliographic review. For this, search engines such as PubMed, Scielo, Cochrane Library or scientific journals, among others, have been used. In addition to websites such as the World Health Organization or the Spanish Ministry of Health. Results: Opioid intoxication has a characteristic triad: Miosis, respiratory depression, and coma. The most effective measure is the administration of the antidote as soon as possible, Naloxone, which is usually administered intravenously and rapidly reverses unconsciousness and apnea caused by opioid intoxication. The initial dose undergoes some small variation according to the guidelines and the authors, but most fix it between 0.2 - 0.4 mg, depending on the severity of the symptoms. Conclusion: The administration of Naloxone can cause withdrawal syndrome, so it is recommended to administer it in low doses and repeat it if necessary. It is possible to prevent opioid intoxication in patients at risk of their misuse, for this it is necessary to carry out a multidisciplinary follow-up from Primary Care and establish alternative strategies such as pain treatment, within a multimodal technique that includes pharmacological treatment, non-invasive interventions. pharmacological, psychological support and rehabilitation.

28

Authors: Rascón Guijarro, M.P

Non-suicidal self-injury (NSSI) is a complex and worrisome phenomenon defined as the deliberate destruction of one’s own body tissue in the absence of suicidal intent. The significant increase in its prevalence in recent years and the multiple negative consequences of this behavior have led it to be considered a public health problem. Despite the inclusion of NSSI in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an independent diagnostic entity, it is still confused with suicidal behavior and other mental disorders. The purpose of this bibliographic review is to understand non-suicidal self-injury in order to find specialized modes of treatment in emergency care. Working on the stigma that surrounds the NSSI and offering training that changes the negative attitudes of professionals can encourage the person to stop hiding this problem and ask for help. Understanding the functions of the NSSI helps to make sense of this behavior, the most frequent function being emotional regulation, which tries to numb unbearable emotional pain through physical pain. A biopsychosocial approach offers a more comprehensive view of self-injurious behavior as complex, multicausal, and multifactorial behavior that stems from painful life experiences. Although there is not much data on the efficacy of interventions in NSSI, systematic reviews and meta-analyses suggest that psychological therapies can help people struggling with self-harm.

16

Authors: Corral Ardila, M

Cancer is a disease with a high prevalence in Spain. In addition, the course of this disease turns out to be very dangerous and difficult for patients who suffer from it. For this reason, many patients tend to suffer a strong emotional impact when knowing the diagnosis of it, also presenting negative emotional reactions, such as: denial, fear, stress, depression, insomnia, etc. Breast cancer, specifically, is the oncological variety that most develops in the female population and also has a high incidence in our country, producing a large number of deaths annually. For this reason, in this article, a bibliographic review has been carried out regarding the psycho-oncological and social aspects of breast cancer in patients, to know in depth how the experience of the disease affects the patients who have it and thus be able to look for some alternatives to improve their quality of life and alleviate the psychological, social and physical consequences that they may suffer.

21

Authors: Gutiérrez López, M.I

Borderline personality disorders are considered a major problem within mental health given their severity and their high epidemiology. The high dysfunctionality in their behavior derived from their severe difficulty of emotional regulation is a central feature of the disorder and is evidenced on numerous occasions in the form of self-destructive behaviors, being its maximum exponent suicide attempts. Borderline personality disorders involve high costs for health systems as well as for patients and their families themselves, especially if we consider that it is a disorder in which prolonged treatments and hospital admissions are usually performed when crises require it. It has also been reported that these patients are often hyperfrequenters of health services. Due to their characteristics, borderline personality disorders pose a significant therapeutic challenge. The complexity of its clinical expression, the high frequency of comorbid disorders and the presence of other elements that prevent the proper development of therapy, such as premature abandonment of treatment, make them often considered difficult patients and the therapy is seen by clinicians and therapists as complex and frustrating. Currently, psychotherapy is positioned as the first-line treatment for borderline personality disorders supplemented with pharmacotherapy aimed at reducing symptoms (1,2). Several psychotherapeutic models have adapted their intervention to limit personality disorders. Dialectical behavioral therapy is undoubtedly the treatment that has had the greatest expansion, being in the current literature frequent references to it. Other forms of treatment such as mentalization-based therapy or transfer-focused psychotherapy have received significant attention from the various authors. Regarding the effectiveness of psychotherapy in borderline personality disorders we find an encouraging situation that shows the benefits that the different therapies exert on improving the reduction of symptoms, reducing self-injurious behaviour or increasing functionality and interpersonal adjustment. Current evidence suggests that dialectical-behavioral therapy is the treatment of choice for borderline personality disorders, showing its effectiveness in both improving the symptomatology of boundary disorders(3) as in the reduction of self-injury and suicide attempts(4). Other therapeutic models such as transfer-focused psychotherapy, mentalization-based therapy or interpersonal psychotherapy, despite having an important place in the treatment of borderline personality disorders have been noticeably less studied compared to dialectical-behavioral therapy. Although the different authors find promising results in psychotherapy, it has been noted that the potency of the studies available to date is weak (3,5,6), so further analysis and study is recommended. The aim of this paper is to analyse new developments in the efficacy of psychotherapy in borderline personality disorders through a systematic review of the studies published in the last 5 years. It also seeks to know the predictors of therapeutic success as well as those that hinder therapy. A systematic review of the studies published in the last 5 years was carried out by searching for clinical trials present in PubMed, PsycINFO and The Crochrane Central Registrer of Controlled Trials databases. Following this review, there is a greater prevalence of studies focused on the analysis of the efficacy of dialectical-behavioral therapy, with the other therapeutic models being the object of less research production. In general, a benefit of psychotherapy is found in the treatment of borderline personality disorders. Some predictors of therapeutic change and abandonment of treatment were also discovered.

33

Authors: Urmeneta Roncal, C

Cancer is the leading reason for death from disease in children in developed countries, and the second most common cause of death in children over one year of age, with accidents being the first. Although cure rates in pediatric oncology have increased, their diagnosis continues to be a major crisis in the family nucleus. In addition to curing the disease, efforts should also be aimed at reducing the side effects and aftermath that the disease itself and its treatments may cause in the quality of life of children and family members. That is why the figure of the psychologist is basic for a good evolution and recovery.

19

Authors: Barrera Baena, P

The metabolic syndrome is a set of clinical-analytical entities that usually occur together have an impact on a substantial increase in cardiovascular risk and mortality for the patient. There is a consensus between the components of metabolic syndrome and chronic kidney disease. This article deals with the above and specifically affects the possible conditioning that chronic kidney disease can entail for treatments used in the control of metabolic syndrome.

25

Authors: Álvarez Muñiz, N

Problems such as obesity and eating disorders are increasingly common in the world. A few years ago they were just specific pathologies, however, nowadays their prevalence only increases. For obesity, new lifestyles have played a significant role: new technologies have replaced doing sport or non-sedentary activities during free-time. Moreover, children prefer to eat high-calorie and high-sugar foods instead of eating a healthier diet. For eating disorders, current lifestyle and new technologies have also played a part in prevalence increase. Teenagers spend a lot of time on the internet where they often find bodies that they think are ideal. This has an impact on their self-steem, diminishing it and leading them to consider changing their bodied with, in many cases, extreme behaviors. These pathologies are largely preventable. Therefore, it is important that all children and teenagers get a good health education, both in diet and healthy lifestyles.

5

Authors: Sánchez Lozano, J., Martínez Pizarro, S

Introduction: Labor pain is an important concern that pregnant women present at the time of giving birth. In recent years, plantar reflexology has been proposed as an adjuvant therapy to reduce said pain. Reflexology is a type of complementary medicine that uses the application of pressure to the feet with specific techniques. The objective of this review is to analyze the efficacy of plantar reflexology as an adjunct to relieve pain in childbirth. Method: A review of the scientific literature is carried out using the PubMed, Cinahl and Scopus databases. Studies conducted in the last eight years are selected, with full text and adequate methodological quality. Results: Plantar reflexology is an effective and reliable adjuvant in the management of labor pain. Regarding the duration of application of the therapy, it ranges between 20 and 60 minutes. The total number of participants in the review was 555 individuals. The instruments for pain assessment were the visual analogue scale (VAS) and the McGill Questionnaire. Conclusions: Plantar reflexology reduces the intensity of labor pain. It also improves other parameters such as the duration of labor, maternal anxiety, increases Apgar scores of the newborn, and increases maternal satisfaction with childbirth.

25

Authors: Delgado Baena, A

Today, anemia is one of the most important public health problems and although its prevalence has decreased, we should not underestimate that about 30% of the population suffers from some type of anemia. On the other hand, 2.5% of the total population presents hematic physiological values outside the statistical normality, as is the case of athletes, African-Americans or pregnant women, where the function of oxygen transport to the tissues is not diminished in said patients cases. In addition, the World Health Organization has collected data that reveals the most common cause of anemia, being iron deficiency or deficiency, especially in risk groups such as the elderly or women of childbearing age. To make a correct diagnosis by the laboratory, it is necessary to determine parameters such as the erythrocyte mass value and other values such as the erythrocyte count, hematocrit or hemoglobin concentration inside the red blood cell.

34

Authors: Pérez San Martín, S., Gómez Fernández, L

The aim of this article is to update knowledge in the study of microcytic anemias, the interpretation of both classical and novel blood count parameters and biochemical parameters used in the evaluation of anemias, the technological principles used by the different blood analysers and stress the importance of the pre-analytical phase to ensure the reliability and traceability of the results obtained.

20

Authors: Cruz Morales, R., Serna del Álamo, J.A

Coronary heart disease is the most important cause of death worldwide. Acute myocardial infarction is an acute coronary syndrome that is characterized by ischemia to a part of the heart muscle produced by the acute and total obstruction of one of the coronary arteries that do not feed Various studies consider that the lack of fiber consumption, diabetes, obesity, tobacco use, sedentary lifestyle, lack of exercise may be predisposing factors for the patient to suffer a heart attack. People who have suffered from this disease can be treated with drugs or catheterization, a technique that consists of breaking up the thrombus and preventing it from re-forming in that area. Thrombosis cases have increased during the COVID-19 pandemic.

23

Authors: Cubero Charco, B

When we talk about cardiogenic shock, we must know that it is a serious pathology, with multiple and varied etiology, with a difficult approach due to the extended tissue hypoperfusion state that can have fatal consequences since it quickly reaches the state of multiorgan failure if adequate treatment is not administered. Over the years, there have been quite a few advances in the knowledge of the physiopathology and development of CS, with the development of CS secondary to acute myocardial infarction being studied in greater detail, advancing with the incorporation of mechanical circulatory support devices to provide an alternative for people suffering from this condition. But it cannot be forgotten that it remains a pathology with a high mortality rate, which exceeds 50% in most cases, and requires an extraordinarily complex, specialized, and economically expensive treatment, which makes it impossible to access in all hospital centers. Like other cardiovascular pathologies, the diagnosis, prognosis, and treatment depend on the underlying cause that leads to this critical state that is CS, but it also has another key factor in determining the above, which is the healthcare center where this pathology is treated. As it is such a specific and complex disease, the effectiveness of centralizing patients who suffer from it in hospitals with specialized equipment, trained healthcare personnel, and evidence-based action protocols has been demonstrated.

32

Authors: Bailo Lalaguna, A

Cardiovascular malaises are the leading cause of mortality in the world, and cardiac emergencies and arrhythmias constitute one of the most common causes of consultation and emergemcy intervention in emergency services in our country. In this article we will discuss them, their diagnosis, clinical manifestations and treatment. The objective of this article is to identify those pathologies who write a deadly ending if its treatment is delayed. Remembering the heart’s physiology will set the first stone to talk about these pathologies. From tachyarrhythmias to cardiogenic shock through lethal arrhythmias, and valvular and aortic pathologies.