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Authors: Lozano Gómez, H

INTRODUCTION: Currently, the research and development of new chemotherapeutic drugs has provided an improvement in the results in terms of their survival in oncological diseases. More and more patients are receiving these drugs and the new adverse effects are still unknown. RESULTS: Patient diagnosed with breast neoplasia in current treatment with chemo therapy and immunotherapy with atezolizumab and abraxane. Admitted for respiratory failure, with negative nasopharyngeal PCR-COVID-19, and perihilar alveolar opacities on the chest X-ray. Infectious etiology was ruled out so it was diagnosed along with the remaining systemic symptoms of a side effect of atezolizumab. In conjunction with oncology, immunosuppressive treatment was decided with mycophenolate mofetil and the evolution was good. CONCLUSIONS: Severe pneumonitis after atezolizumab is one of the side effects described, although fortunately rare, so its diagnosis is sometimes difficult assuming from the beginning an infectious etiology in a depressed patient

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Authors: Castaño Espejo, A.C

Introduction: Myofascial pain syndrome (MPS) at the lumbar location is one of the most incident pathologies, with an estimated 85% of citizens of developed countries will experience this pain at some time in their life. MPS is a non-inflammatory disorder and manifests clinically as a chronic severe pain. There is no effective therapy against myofascial pain. Nowadays, non-invasive techniques are being used, among which the dry needling stands out for its encouraging results, but its scientific evidence is scarce. The objective of the present work was to determine the therapeutic effectiveness of dry needling to relieve pain in patients with lumbar MPS. Methodology: a systematic review has been designed, whose strategy for looking studies was based on electronic databases (Pubmed and PEDro), the use of keywords, the establishment of limits and criteria for the selection of studies, and evaluation of the quality studies (PEDro scale). Results: six studies were included, with an average methodological quality of 7.6. Dry needling decreased pain intensity, pressure pain threshold, sensitivity and disability of patients with myofascial low back pain. The needles of greater caliber (0.9 mm) were more effective, and if this technique is complemented with education in neuroscience it will be more effective to decrease kinesophobia. Furthermore, it was observed that the efficacy of dry needling was similar to that obtained with pharmacotherapy. Conclusions: dry needling is an effective non-invasive technique to reduce pain in patients with lumbar MPS.

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Authors: Mediavilla Álvarez, E

Systemic lupus erythematosus is a complex chronic autoimmune disease and whose main symptoms are manifested with arthritis and joint pain, fatigue, erythema malar, oral ulcers, photosensitivity, serositis, osteoporosis, renal disorders, blood immunological. With advances in medicine and treatments this disease is considered chronic but not fatal as such, although it is true that the severity will depend on the involvement and sensitivity of the patient to the disease. In this work the disease and its characteristics will be defined, we will identify the various symptoms and will thoroughly treat the area of treatment of the disease clinic, with special emphasis on joint pain and the recommendations that the patient with systemic lupus erythematosus should follow in order to have an acceptable quality of life that allows him to lead a normal life.

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Authors: Fernández Cadenas, Ángeles

Background: Respiratory physiotherapy techniques play a fundamental role in mucociliary clearance in cystic fibrosis (CF), but it has not yet been possible to demonstrate superiority of one technique over another. The objective of this study is to know the short-term effects of drainage of bronchial secretions using the autologous drainage technique (AD), a technique preferred by patients, with lung function tests (PFR) and measurement of the pulmonary clearance index (LCI) using the technique of washing nitrogen with multiple breaths (N2MBW), in patients with clinically stable cystic fibrosis. Methods: Nine subjects have been studied and have been measured SVC, FEV1, FVC, FEF25-75, FRC and LCI before and after a 30-minute AD session. Results: No significant differences were found in ICD, only one subject improved significantly, i.e., the ICD decreased by 1.8, and three other subjects improved with a decrease of less than 1 point, but we did find a slight significant decrease in CRF of 200 ml in the total sample (p=0.032) and an increase in SVC of 2.55 2.06 %, with a value of p=0.03. No significant improvement differences have been found in PFR, nor have significant correlations. Conclusions: A 30-minute session of AD has not generated significant changes in ventilatory inhomogeneity in this group of patients.

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Authors: Souza Fernández, Marta

Introduction: The shoulder is the articulation of the human body with the highest range of movement, due to the anatomical elements that compose it, which, in addition, give it enormous complexity. The structures it contains provide functionality to the upper limb, but are also exposed to multiple pathologies. Musculoskeletal disorders of the shoulder develop and become more complex over time until the onset of joint pain. There are data that one in three people experience shoulder pain at some stage of their lives and even about half of the population suffers at least one episode annually, plus the incidence is 30-50% of all sports injuries, according to various authors. Shoulder pain occupies the second place after low back pain, and affects approximately 16-21% of the population. The most frequent cause is subacromial impingement syndrome, estimated 44-60% of medical consultations for said pain. In Spain, prevalence figures of 78 cases per 1,000 inhabitants have been reported, leading to a significant consumption of care resources and productive losses due to absenteeism in the workplace. The majority of those affected are under the age of 60. Its symptoms are usually related to the work performed or the sports activity performed, especially in those that require the use of the hand above the head. Rotator cuff tendinopathy is the most common cause of upper limb dysfunction pain and increases its appearance with age. Most of the population that suffers from these shoulder discomfort is due to the set of muscles called the rotator cuff and the surrounding tissues. Treatment includes surgical and non-surgical methods. The goals of non-surgical treatment will be to reduce subachromial pain and inflammation, treat the compromised rotator cuff, and restore shoulder function. Objective: Our review aims to look for the different treatments that demonstrate the efficacy of physiotherapy for this pathology. This literature review aims to analyze the different techniques of physical therapy in the treatment of supraspinatus tendinopathy, in order to capture whether there is evidence as to whether or not the conservative treatments offered by physiotherapy through its various techniques are effective, in order to avoid surgery, pharmacological treatments and/or more invasive therapies. Material and method: a systematic review is carried out in Medline, Pedro, Cochrane, and Science Direct on the treatment of physiotherapy against the subachromial syndrome, using the following keywords: physiotherapy, physicaltherapy, rehabilitation, impingementsyndrome, subacromialsyndrome, shoulder, pain. The search is limited to articles published in the last five years. Following the application of the inclusion and exclusion criteria, 16 articles were selected and deemed appropriate to meet the objectives of the review. Results: After analyzing the selected studies, it is observed that in each of them there are positive results in the application of physiotherapy treatment, conservative, by applying one or more techniques to the pathology of supraspinatus tendinopathy without taking into account the etiology. Conclusion: There is evidence about the treatment of physiotherapy in patients with supraspinatus tendinopathy.

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Authors: Pons Albert, Francesc

One of my main concerns as a physical trainer has always been to prevent my players/ras from getting injured. Specifically, the rupture injury of the anterior cruciate ligament is a very serious and common injury among basketball players/ ace, field to which I dedicate myself. This is why in this document I have tried to compile and compare the main scientific studies that address the issue from a sports point of view. The objective of this paper is to offer a global and updated vision focused on the prevention and recovery of injury.

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Authors: Toro Martín, S

Giving birth is certainly one of the situations in a woman´s life that causes the strongest pain in her life, which on various occasions can be excessive and unbearable. Due to this, good pain management during delivery is essential so that the care provided by the health team is adequate and has quality. Currently, epidural analgesia is the most widely used during obstetric procedures related to childbirth, although this technique is invasive and like any invasive procedure, presents risks for pregnant women and the foetus. To develop this assignment a systematic bibliographic review has been carried out in order to analyze the existing literature on the subject in the most important scientific databases. Therefore, the objective of this study is to obtain remarkable information on the relationship that may exist between the use of epidural analgesia during labour and the increase in the length of the dilation phase, the expulsion phase or if it influences in any way the increment in the number of deliveries that require the use of supporting instruments or involve any other complicated situations. In conclusion, it can be confirmed that epidural analgesia is related to a longer dilation time, an increment on the time dedicated to the expulsion phase, in the same way that there is an increment in deliveries that require the use of supporting instruments, the use of medications such as oxytocin or the association with additional complications.

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Authors: León Soto, M

Objectives: Determine the main interventions of the midwife for the prevention of perineal trauma that occurs during childbirth, review and detail the effectiveness of the main interventions during pregnancy and delivery for the prevention of perineal trauma, describe the role of the midwife on interventions for the prevention of perineal trauma. Method: Bibliographic review of scientific articles in databases PubMed, MedLine, Cinahl, Scielo, Dialnet, Cuidatge, published in the last 5 years, in Spanish, English and Portuguese. Books and some guides have also been included. No ethical restrictions or limitations were made. The abstracts and, if necessary, the complete articles were reviewed, taking into account all the articles that met the selection criteria. Results / Discussion: Interventions of the midwife who have enough literature to have scientific support in the prevention of perineal trauma are: Exercises during pregnancy to strengthen the pelvic floor, perineal massage during pregnancy, maternal position during the expulsive, spontaneous pushing techniques, hands-free or hand-off technique and application of hot packs. Conclusion: We have indicated several interventions as beneficial in the prevention of perineal trauma. However, more reliable studies are needed to support these interventions, we must join efforts in the dissemination of the results among the different health professionals for their subsequent application to the daily work and thus make interventions for the prevention of perineal trauma a reality.

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Authors: Garnica Martínez, I

During the last century the management of childbirth has undergone an intense transformation. Until half a century ago, most deliveries took place in the pregnant woman’s own home, assisted by a midwife, where health conditions were generally not optimal (no running water and heating) as well as the nutritional and health conditions of many women. All this, together with the fact that the number of children was high and the short inter-seasonal space, made the maternal and infant mortality rate during childbirth very high. Over the years, the practice of giving birth in the hospital was imposed, which significantly reduced these mortality rates. However, the process of hospitalization of births also brought with it some negative consequences: an increase in the number of caesarean sections, episiotomies and inductions of childbirth far above the recommendations of the World Health Organization (WHO) and, in general, a "dehumanization" of the process. With the rigid application of hospital protocols and the widespread use of epidural analgesia in childbirth, It is extremely common to disconnect women with their experiences and use techniques and drugs to conduct a childbirth in which the complex hormonal mechanism that guides it is disrupted. One of the most widely used drugs in obstetrics, along with anesthetics, is synthetic oxytocin in order to produce or increase the number and intensity of uterine contractions. The use of this endogenous oxytocin analogue causes the hormonal feedback system to be interrupted and the endogenous oxytocin secretion to be completely modified. The most well-known physiological functions of oxytocin have to do with the production of contractions as an engine of childbirth and the initiation and maintenance of breastfeeding. However, it has been found that the hormone oxytocin is responsible for modulating many behaviors of relationship and attachment of the human being among other functions, of which, there is still a great ignorance. This literature review attempts to explain what short- and long-term consequences the massive use of synthetic oxytocin may have during in-hospital management of childbirth.

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Authors: Álvarez Mesa, J

Pressure ulcers are ischemic lesions, located in the skin and underlying tissues, that cause rapid tissue degeneration. They are usually caused by immobility and pressure on bone surfaces, which is usually common in patients with physical disabilities. Their care is based on their prevention, on their evaluation once they have appeared or if the patient already suffered some and finally in the treatment of injuries.

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Authors: Rigo Montserrat, A,J

Introduction: Pressure ulcers today are a health problem to consider, especially in people considered at risk, since they directly affect the patient´s quality of life and their environment. In addition, the cost of treating pressure ulcers, both personal and economic, is very high compared to the cost of prevention. Therefore, it is decided to carry out a systematic review to be able to group the latest recommendations at the level of pressure ulcer prevention in order to have help in deciding how to act before our patients. Objectives Collect the latest advances in UPP prevention. Compare different techniques and products designed to prevent UPPs and clarify, if possible, which are more effective. Emphasize the importance of good prevention to save costs and improve the quality of life of patients. Material and methods: A bibliographic search of articles related to the prevention of pressure ulcers of the last 5 years and of free access was carried out in the Pubmed, Cinahl and Cochrane Library databases. Main results: After the literature search, 94 candidate articles to be used for the review were found. Finally, 47 articles were used, excluding the rest because they were not freely accessible or did not meet the inclusion criteria. Conclusions: The review has been able to help us identify and obtain figures for the cost of treating ulcers, both personal and economic, and has made it clear that investing in good prevention is very important and is more beneficial for everyone. With the review we have grouped the latest advances in prevention and deny false beliefs, being able to use the information to carry out an updated prevention protocol.

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Authors: Calzado Bravo, C

Introduction: Pressure ulcers (PU) are a serious problem that affects hospital centers. The ICU is the environment where the incidence of this type of injuries is higher. The risk factors that occur in these environments make this sea scenario procure the development of the UPP. This is why it is necessary to establish protocols and nursing activities in the evidence in order to reduce the incidence figures in this environment and improve the quality of life of the patient. Objectives: To identify the recommendations for the prevention of UPP in ICU based on evidence. Methodology: A bibliographic search is made of articles from the following databases: PUBMED, CINAHL (EBSCO), CUIDEN PLUS, LILACS, ENFISPO and the COCHRANE PLUS LIBRARY. The first search was carried out with the search engine of GOOGLE SCHOLAR and the search engine offered by the University of Jaén (BUSCAENBUJA). Results: The final sample consists of a sample of 20 articles obtained in the different databases with previous connection. In addition, consult the clinical practice guides and technical documents of the GNEAUPP. The results were organized into two main ideas; first of all it is called of the intensive care units and their risk factors and secondly, we talk about the main prevention measures of UPP in ICU. Conclusion: The implementation of UPP prevention protocols has been demonstrated in the reduction of UPP figures, improving the evolution of the lesion if present and the quality of life of the patient.

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Authors: Castillejo Tornín, D

Pressure ulcers are one of the biggest challenges for the nursing professional in particular and health care in general. The presence of these lesions is growing in the health field, and they are present in both public and private centres, of an acute or chronic nature. Healthcare professionals must be prepared for the management of this type of lesion, since not only should their presence be highlighted in patients who already suffer them, but there are a multitude of patients who are at risk for various reasons. That is why, as healthcare professionals, we must not allow our actions or lack of knowledge to generate a situation of additional risk to the patient, in which the patient can develop this type of injury due to errors associated with our malpractice. In the health field and outside it, we must be aware of the situations of greater risk in the patient and of how we must manage these situations, to try to prevent the appearance of these wounds in situations where their appearance is close. The health field is one in which should never develop this type of injury, so we must be aware of the risk situations that can occur within this.

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Authors: Fernández Salomón, I

In the recent years, health professionals must deal with an increasing number of patients who have wounds difficult to treat. Skin ulcers are a problem that occurs in a big amount of people with diverse pathologies, hospitalized or with reduced mobility. These ulcers are avoidable in a high percentage of cases, if dietary and hygienic measures were being followed. In many cases, it is not possible to prevent its appearance, due to caregiver’s difficulty, combined with other factors such as lack of good nutrition, etc. To know how to treat this type of skin lesions will, therefore, be the first priority. Over the years, we have seen the evolution of the techniques and products used for their treatment, but the increase in the number of brandnew kinds of dressings and its utilities in concert with the lack of knowledge of themselves, makes it difficult to choose the most suitable one in each case, so they are frequently used wrong. To be familiar with their functions and applications would greatly assist in health sector because it would accelerate the healing process of the wounds, and it would also reduce health costs. This project is focused to review each type of bandage in detail, its indications and contraindications and all the relevant related information, gathered by the synthesis of pertinent literature. Its purpose is to help in the selection of the best dressing, based on the prior knowledge of their therapeutic indications.

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Authors: Álvarez Cuervo, B

Ulcers present a significant conflict in public health that affects all levels of care. They integrate a great diversity of elements that are integrated on the arrival of pressure ulcers, being subject to the absolute activity of such as main generator of them. The forecast of pressure ulcers is the most significant, since it hinders the breakdown of the dimension of existence of the patients and minimizes the time of permanence of hospital admission, fully developing this through a list of applications, produced as a group with various health jobs. If an ecchymosis occurs, the most appropriate approach will be chosen about the time of healing and healing so that the hospital admission is not maintained for a long time, also avoid infections, which has a routine negative impact on the evolution. Nursing graduates are the most committed as are all tasks, taking on some of them in others. Likewise, the activities of suspicion and procedure of nurses and nurses will also carry out health care for the sick and/or relatives, so that these guidelines are maintained in their accommodation. The objective of the risk assessment is the identity of the types requiring prophylaxis measures and the identity of the specific delegates who put them in danger. The risk assessment scales used are Braden, Norton, Emina, Waterlow and Cubbin-jackson. The estimation of the danger that a patient can develop to expose UPP is, above all, a basic adema in the prophylaxis. The clinical practice guidelines suggest that a risk assessment be carried out in all patients who are admitted to the health system, in the same way in hospitals, in elderly groups or in patients assisted in their accommodation. The purpose of hazard estimation is the filiation of persons requiring measures of suspicion and the identity of the specific coefficients that classify them in a position of danger. But at the moment, there is no specific agreement between researchers and practitioners on what is the most effective way to carry out this risk assessment of developing UPPs. Some of the methods of working in older health centers have as essential the clinical process of nurses and put the method of estimation stairs as a complement, on the other hand, others currently treated think that many of the stairs obtained should be a more optimal option than clinical litigation, especially when we refer to non-expert nursing staff.