NPunto

13

Authors: Castillo Salas, L

Social determinants play a fundamental role in the processes of health and illness, being factors which affect the ability of all people to exercise their right to health. All sociological studies concur that illness is a social problem which is not merely limited to biological and individual factor, and as such, the influence of the social, political, economic, and cultural organisation of a society must also be considered. For this reason, addressing individual and collective health requires a multidisciplinary focus, in which social intervention is assumed by the social healthcare worker, especially when dealing with Covid-19 or mental illnesses. The consequences of this for the quality of life of the patient is the principal focus of this thesis, along with the different ways in which health may be promoted.

26

Authors: Villén Peinado, M.F

Pressure ulcers (PUs) are injuries to the skin and tissue underneath, resulting from prolonged pressure on the skin overlying bony parts of the body, such as heels, ankles, hips and coccyx. The risk of pressure ulcers increases if you are bed-ridden, or use a wheelchair and therefore also cannot make postural changes. PUs are a problem for society, both for the person who suffers from them and in terms of economic expenditure, as human and physical resources are used, resulting in long periods in hospital or attending to them in primary care, if they are not properly cared for, they can be life-threatening. From the pharmacological point of view pressure ulcers have the characteristics depending on their stages and such lesions. The main purpose to address the healing or treatment of pressure ulcers would be, on the one hand céntranos in the healing is achieved in the shortest possible time, using for them the best resources. Pressure ulcers are undoubtedly one of the most relevant and important issues in our society, as they have an excessive overall cost for the health system due to their incidence and prevalence. With all of the above, patients suffering from pressure ulcers have repercussions on their activities of daily living, which can even reduce their activity, while on the other hand it represents a high health care cost. For the WHO, the incidence of PUs is one of the indicators for determining the quality of care provided by the hospital network. In order to achieve the objective of healing pressure ulcers, the main thing is to quickly identify and use the necessary resources for healing as well as the appropriate choice of the therapeutic method to be chosen. At this point, it is necessary to invest time and knowledge to educate patients and primary caregivers about the importance of proper nutrition, which has an implicit impact on improved healing and prevention, as well as the important role of postural changes. The importance of home care for bedridden patients is important in preventing the development of pressure ulcers. Close collaboration between caregivers and professionals is necessary. Before starting treatment, a general assessment of the patient, his or her physical and psychosocial situation and the ulcer is necessary. In order to provide more complete information about pressure ulcers and their treatments, it is of interest to survey current publications on this condition through a bibliographic review of scientific and academic publications in books, scientific journals and specialised medical websites. The literature reviewed maintains the idea that the key to addressing PUs remains the assessment of risk factors for ulceration. Pressure ulcers will not heal unless the underlying causes are effectively addressed. The overall assessment needs to encompass identification and appropriate and effective therapy of the pathology, disease, nutritional status, psychosocial aspects and degree of pain, all of which leads to the conclusion that there is a high rate of developing pressure ulcers (PUs).

39

Authors: de Pablo Martínez, L

Physical activity is an important factor not only to improve quality of life, but also to prevent the progression of the disease, regardless of whether its etiology is physical or mental. In old age it becomes even more relevant and that is why psychomotor reeducation helps the elderly to improve both physical and cognitive capacity, as well as the way they relate to their peers and the environment.

20

Authors: Benítez Estupiñán, Y.M

Food is the ingestion of food by organisms to provide their nutritional needs, mainly to get energy and develop. This process is even more important during pregnancy since it not only nourishes the future mother but also the development of the future baby and later in lactation. In this very important stage of life, it is determined by an increase in maternal nutritional needs of almost all nutrients in relation to the preconception period. In case of nutritional deficiencies and imbalances in pregnancy, it can cause problems of prematurity and infant mortality and chronic diseases such as type 2 diabetes, hypertension, cardiovascular diseases and obesity among other pathologies. Various studies also relate it to a higher rate of neonatal morbidity and mortality. During pregnancy, the diet must be complete, balanced and varied to maintain the health of the pregnant woman and the baby. This diet must be rich in nutrients, vitamins and minerals in order to follow an adequate development of the mother and the future newborn. Therefore, it is advisable to change or take into account aspects in the diet that will help us have a more pleasant and healthy pregnancy. As general rules, foods such as meat and fish should be cooked well, always better grilled or boiled to maintain a correct BMI during pregnancy. It is recommended between half and a liter of milk a day or its equivalents. Reduce foods with excessive amounts of fat of animal origin, such as butter bacon, cold cuts, pastries. In case of not carrying out an adequate diet during pregnancy, the future baby will have to adapt to this situation and may have difficulty adapting and thus increase the probability of cardiovascular and metabolic diseases in adult life.

23

Authors: Fernández Rodríguez, G

I have chosen this Master´s Final Project because I would like to expand the knowledge in my professional categories in order to be able to improve as a healthcare professional, and which is more, as a human being. Giving good patient care and the best solution to their problems gave me enough motivation to investigate the world of food within sports injuries, since they are the most common in my service. As a nurse and physiotherapist, I know that it is very important to have a good diet. In the world of sports, it is known that one of the most frequent causes when an athlete suffers an injury is related to poor eating habits in daily life. For this reason, I am going to carry out this research based on the relationship between food and sport. At the same time that this relationship is studied, an investigation will be carried out to know all the characteristics and all the nutrients within the diet, the energy that they provide to the body to carry out a correct metabolism and the benefits of a good diet, especially in sports life. As a conclusion to this research, different model diets will be proposed so that anyone, athlete or non-athlete, could follow a good diet to reach a healthy life

27

Authors: Benítez Florido, A

Eating disorders are a very important public health problem, since in recent years the number of young people who suffer from it has increased, as well as the age range has decreased. These are based on having problems related to physical image and weight, which ends up translating in one way or another, into a deterioration of the eating pattern. These disorders have a multifactorial origin and lead to negative consequences in all spheres of the human being. Therefore, it is necessary to be aware of the importance of prevention in vulnerable people. In addition, to carry out an early diagnosis and a multidisciplinary approach to cover the problems that underlie the disorder from different perspectives. Nurses play a very important role in the care of these patients, since they not only focus on the administration of drugs, but also cover the emotional and psychological aspect, thanks to the care plans. In addition, it has been verified that many activities and interventions carried out by nurses (relaxation therapies, active listening, self-esteem enhancement, support groups or laughter therapy) have a positive effect on the evolution of the disease, as well as on the patient´s mood.

19

Authors: Martí Molins, M.F

Improved radiation protection in the medical field requires a better understanding of the dosimetry and methods of protection of patients, staff and the public in general. The effects of radiation on children are more harmful, so it is important to perform proper radiation protection. The International Commission on Radiological Protection (ICRP) has established three principles that have also been recommended by the EURATOM (European Atomic Energy Community) directive 97/43: protection, limitation of radiation doses for exposed persons and justification of the practices. Radiation safety can be achieved by maintaining the consistency and accuracy of an established radiation protection program. However, insufficient knowledge of the protocols and practice of pediatric radiation doses has contributed to these patients receiving a higher radiation dose than is necessary. The objective of this work is to know the methods of pediatric radiological protection and their effect in the prevention of diseases related to ionizing radiation. For this, a systematic review was carried out using the PubMed, ScienceDirect and Virtual Health Library (VHL) databases. The terms used were: Ionizing radiation, Radiological Protection, Radiation protection, Pediatrics, Childhood and Radiation risk. A total of 152767 articles were obtained, of which 10 articles were selected where research protocols and studies on radiological protection in pediatrics were applied. The results showed that children exposed to ionizing radiation are theoretically subject to an increased risk of carcinogenesis compared to the general population and that pediatricians´ knowledge about radiation dose should be improved.

27

Authors: Ranera Díaz, F.F

Pediatric transport allows the pooling of material and human resources to improve patient care, especially in places where access is more difficult and allows adequate patient care and specialized emergency care. The handling is essential to guarantee a good service, they must be prepared for the knowledge of the pathologies, anticipate and stabilize the patient for the transport. The main objective is to describe the different types of pediatric transport in currently seriously ill patients. A systematic review was carried out. It was carried out through a search in different databases described below, such as: PubMed, Embase, Cochrane Library, ScienceDirect and the Virtual Health Library. A total of 32,860 review articles were found, after using the Mendeley bibliographic gesture and applying inclusion and exclusion criteria, 16 articles were finally obtained that met the criteria of the publication time frame, in full text, in English and Spanish, in pediatric patients. , where pediatric transport was addressed as a topic of study. In conclusion, there is no balance in terms of the distribution of resources available to the pediatric population, and in the options for interhospital transfer. Children have a constitutional right to receive the best care. It is necessary to carry out activation protocols for specialized care units. Studies in pediatric transport are necessary to take actions that allow improvement in their performance.

35

Authors: Torrecilla Cañas, J

Acute liver failure is a syndrome characterized by massive liver necrosis and sudden-onset severe liver dysfunction in previously healthy children. It is a rare entity in pediatrics but rapidly progressive and of extraordinary severity and morbility and mortality, since in almost half of the cases it leads to the death of the child or the need for a liver transplant, although the new use of extrahepatic purification techniques and the greater experience in liver transplant have significantly improved their prognosis. The etiology is unknown in around 30-50% of cases, but its study is essential to be able to establish specific treatments and make a more accurate indication about the need for liver transplantation. For this reason, various protocols or guidelines have been created for a step-by-step diagnostic approach to this entity. It requires a multidisciplinary approach within an experienced health center, initially the treatment consists of support measures and treatment of complications, especially to prevent or treat hepatic encephalopathy, all with the hope that the liver will recover spontaneously or by doing an indication for a transplant at the most appropriate time, in order to avoid a late indication that puts the child´s life in danger, but without carrying out more transplants than are strictly necessary, especially due to the implications that this has throughout the life of the child for the rest of the patient´s life. Due to the latest advances in the diagnosis and treatment of acute liver failure, the following work intends to synthesize all the current knowledge about this entity.

21

Authors: Hernández Rodríguez, M

To day of 2020 December 16, there have been reported 1,539,594 cases of COVID-19 in Spain, of which: 7,975 have required admission to the ICU (0.5%), and a total of 19,087 have died. This bibliographic review aims to compile a compilation of those articles, documents and research published in different databases and scientific journals since the beginning of 2020, of those patients admitted to the ICU for COVID-19, thus relating said clinical worsening with the various characteristics, comorbidities and mortality rate, in order to obtain a clinical profile that allows us a probable prediction of admission to the ICU in patients with SARS-CoV-2. Therefore, the main objective of the review will try to define the most prevalent comorbidities, clinical signs and laboratory parameters in critically ill patients who died from SARS-CoV-2. It was found that a strong association between admission to the ICU and mortality of COVID-19 patients: With at least 1 previous comorbidity, the most frequent being hypertension or cardiovascular diseases; male, elderly; with a considered elevation of CRP, fibrinogen, D-dimer, troponin, and liver-enzymes; with a marked decrease in lymphocytes, white blood cells and albumin; a blood glucose > 180 mg/dl; a saturation lower than 88% with respiratory failure, and the requirement of IMV.

24

Authors: Benavente Sánchez, S

Post-intensive care syndrome is a relatively new entity, affecting a significant number of patients after discharge from the ICU. It presents with very varied symptoms, including cognitive deterioration, physical weakness and psychological problems that remain latent years after admission to the unit, affecting later quality of life. Despite being a complex syndrome, there are programs that allow us to prevent and treat it, although our limited experience translates into underdiagnosis and little treatment. Within these measures, the eCASH model and humanization programs have shown a clear benefit in the prevention of PICS, although this is a territory in which much remains to be investigated. The SARS - CoV - 2 pandemic has been a dire scenario for patients with PICS. The psychological sequelae of these patients have been added to the consequences of distancing measures and restrictions, limiting on many occasions the correct management of this syndrome. Despite the lack of studies in this regard, the PICS poses a serious public health problem, and requires more research to slow its progress.

27

Authors: Suesta Adelantado, H

Pediatric intensive care units are an essential part of the treatment of critically ill children. This being the main objective of the assistance activity. In the 21st century, when medical science has advanced so much and with increasingly new, special and sophisticated techniques, the role of pediatric and neonatal ICU Nursing must be impeccable in terms of praxis, the search for scientific evidence to keep abreast of the best knowledge and as regards its implementation, of course, an exquisite human treatment for small patients as for their distressed relatives treating them as a unitary patient-family system and always from a holistic and bio-point of viewpsycho-social to help them make the difficult journey through an intensive care unit for children or family members easier. Critical or intensive care units are as we have said very sophisticated units that make use of a large number of complex technological equipment that requires staff knowledgeable about their operation, at the medical, nursing and auxiliary nursing care technicians level.

22

Authors: Noval González, A

Introduction: Cancer is one of the leading causes of death in the world. This disease has a great impact on the patient and his environment, not only physically, but also psychologically, due to the diversity of types of cancer that exist. It involves multidisciplinary work integrating commitment, dedication and interaction. Objective: The objective of this work is to know and evaluate the psychological impact of the patient and his family, as well as to implant techniques to face this situation. Methodology: The bibliographic search was carried out from October 2021 to February 2022 using electronic databases such as PubMed, Medline, Elsevier and Scielo and evidence-based journals such as Cochrane, to access through them recent publications of scientific studies on cancer, mostly published from 2016 onwards. Development: Oncological disease has an enormous impact on the patient and on his or her family and social environment, which is in danger. It has been seen that emotional responses vary depending on certain factors: The stage of the disease process in which the patient is located, personal and family circumstances at the time of diagnosis, the previous experience of the patient with such pathology, the support systems they have, the treatments administered, etc. We will implement various techniques to cover every emotion that this entails. Conclusions: The importance of knowing and evaluating individually how the disease affects the patient and his whole environment. Each person has a way of facing it, each one lives each stage in his own way and must know how to support him. Continuity of care should be ensured by coordinating the different levels of care within a framework that promotes the active participation of the patient/family unit.

26

Authors: Nafría Jiménez, B

Colorectal cancer (CRC) is a malignant tumour that appears in the colon and rectum, from lesions called polyps. Some polyps (adenomatous) are premalignant lesions that can transform over the years into cancer. These premalignant lesions and early CRC are characterized by intermittent inappreciable blood loss in the stool, which can be detected with laboratory tests before the patient have clinical manifestations, which allows early detection. CRC does not usually present symptoms until it is in an advanced stage, hence the importance of early diagnosis and population screening programs. However, the symptoms that have been identified as the most common are: changes in bowel habits, digestive bleeding and abdominal pain. CRC is a global public health problem, especially in the most developed countries, and represents the first positions in both incidence and mortality. Risk factors include age (>50 years), diet, as well as family history. The usual treatment is the removal of these lesions, thus preventing them from progressing to cancer and/or treating it, if CRC already exists, with adjuvant chemoradiation therapy.

32

Authors: Ruiz Artero, M

Cancer is a genetic disease, so there are some types of cancer that can be inherited from parents. In this topic we will develop the main genetic bases of cancer, the type of mutations that occur, the mechanisms of cell repair, proliferation etc. We also see the most important syndromes of hereditary predisposition to cancer, They can be: hereditary predisposition syndrome to breast cancer and ovarian cancer, Lynch syndrome, colorectal cancer, family melanoma or neurofibromatosis among others. The clinical manifestations of these syndromes, the incidence in our society, the main genes involved genes such as BRCA1, PALB2 APC or NF1 and the instrumental techniques by which these alterations in genes are diagnosed, In this we find the PCR polymerase chain reaction, massive sequencing, MLPA or microarray.