Privacy and intimacy of patients within the health system are usually understood as confidentiality of both the medical records and the identity of the patients enrolled in research as well as the ...ethic implementation of biotechnological advances. Nevertheless, we forget that intimacy is the set of feelings and thoughts each person keeps inside as an expression of his/her own identity. To protect this identity is a right.
The loss of the hospitalized patient’s intimacy is a destabilizing agent, which can trigger anxiety and regression scenarios and other somatic expressions.
There is a lack of studies regarding the right to intimacy of hospitalized patients. Although the current law approaches the right of intimacy, there are not enough studies analyzing either the factors identifying these rights or the correlation between the opinion of patients and proffessionals regarding this topic.
OBJETIVES: To identify the rights related to intimacy in hospitalized patients; to analyze the correlation between rights identified by patients and nursing staff; to develop a charter gathering the privacy and intimacy rights of the hospitalized patient.
METHODOLOGY: We propose a cross-sectional study including 196 patients admitted in the Fundacion Jimenez Díaz Hospital (Madrid) and 178 nursing proffessionals working there. All of them will answer a questionnaire regarding issues related to the rights to intimacy designed and validated by the research team.
Cuando se habla de respeto a la intimidad en el contexto sanitario se entienden aspectos tales como la confidencialidad de los registros médicos, seguridad de la identidad del paciente en publicaciones ó la aplicación ética de las novedades biotecnológicas. Olvidándose de que la intimidad es el conjunto de sentimientos y pensamientos que cada persona guarda en su interior como expresión de su identidad y cuya salvaguardia es un derecho. La pérdida de la intimidad del paciente hospitalizado es un agente desestabilizador que puede desencadenar cuadros de ansiedad y regresión y otras expresiones somáticas desestabilizadoras. Son escasos los estudios sobre la percepción del respeto a la intimidad de los pacientes hospitalizados y aunque en la legislación vigente se aborda el derecho a la intimidad, no existen suficientes estudios que analicen los identificadores de estos derechos ni el grado de concordancia de los mismos entre los pacientes y el personal de enfermería
OBJETIVOS: Identificar los derechos relacionados con la intimidad de los pacientes hospitalizados; averiguar el grado de concordancia entre lo que los pacientes y el personal de enfermería identifican como derechos relacionados con la intimidad; elaborar una carta del paciente hospitalizado en relación con estos derechos.
METODOLOGÍA: Estudio transversal en 196 pacientes ingresados en la Fundación Jiménez Díaz (Madrid) y 178 profesionales de enfermería (enfermeras y auxiliares) que trabaja en la misma. A todos ellos se pasará un cuestionario sobre aspectos relacionados con el derecho a la intimidad.
•The spatial distribution of NH3 levels was investigated in six major Spanish cities.•Seasonal differences in NH3 levels were not consistent among cities.•The relationship between NH3 and ...vehicles/km2, SO2, NOX and PM10 was assessed.•Urban NH3 sources: traffic, biological, solid waste and wastewater plants, industry.•Mitigation strategies on urban NH3 are important to meet limit values of PM mass.
A detailed spatial and temporal assessment of urban NH3 levels and potential emission sources was made with passive samplers in six major Spanish cities (Barcelona, Madrid, A Coruña, Huelva, Santa Cruz de Tenerife and Valencia). Measurements were conducted during two different periods (winter–autumn and spring–summer) in each city. Barcelona showed the clearest spatial pattern, with the highest concentrations in the old city centre, an area characterised by a high population density and a dense urban architecture. The variability in NH3 concentrations did not follow a common seasonal pattern across the different cities. The relationship of urban NH3 with SO2 and NOX allowed concluding on the causes responsible for the variations in NH3 levels between measurement periods observed in Barcelona, Huelva and Madrid. However, the factors governing the variations in A Coruña, Valencia and Santa Cruz de Tenerife are still not fully understood. This study identified a broad variability in NH3 concentrations at the city-scale, and it confirms that NH3 sources in Spanish urban environments are vehicular traffic, biological sources (e.g. garbage containers), wastewater treatment plants, solid waste treatment plants and industry. The importance of NH3 monitoring in urban environments relies on its role as a precursor of secondary inorganic species and therefore PMX. Further research should be addressed in order to establish criteria to develop and implement mitigation strategies for cities, and to include urban NH3 sources in the emission inventories.
Introduction
HLA sensitization is a growing problem in children awaiting kidney transplantation. In some cases, finding an immunologically compatible donor entails contemplating the option of an ABO ...incompatible transplant or paired transplant.
Methods
Patient with genetic nephrotic syndrome and progressive chronic kidney disease, with a previous thrombosis of a first kidney transplant, resulting hypersensitized and remaining for a long‐time on hemodialysis. Despite a desensitization strategy, family members were incompatible and deceased donation options must be ruled out due to the presentation of donor‐specific antibodies (DSA). After 4 years, the possibility arises to perform a kidney paired transplant with a 62‐year‐old woman with an incompatible blood group. Although the current cytotoxicity‐ and cell‐based crossmatches were negative, history of DSA were recorded.
Results
An intensive ABO and HLA desensitization protocol was performed in order to combat the isohemagglutinin antibodies and on the memory‐HLA, based on rituximab, apheresis sessions, and immunoglobulins. Despite the donor being older in terms of pediatric transplantation, the donor‐recipient weight difference, and immunological risk, the transplant was completed successfully. Maintenance of titration of up to 1/2 was confirmed after 3 weeks post‐transplant (IgM and IgG). Kidney biopsy at 2 weeks and 6 months without signs of rejection. The patient is currently 12 months post‐transplant and has not presented any signs of transplant rejection and has proper renal function.
Conclusions
Kidney paired transplantation is an excellent solution for hypersensitized children, and ABO incompatibility can be considered to increase their options to find a good donor, without thereby obtaining worse results.
Background
Diarrhea is one of the most frequent class adverse events associated with targeted oral antineoplastic agents (OAAs). Our objective was to analyze the incidence, characteristics, and ...severity of diarrhea in cancer patients in clinical practice.
Methods
An observational, longitudinal, and prospective study of cancer outpatients treated with targeted OAAs was carried out in a tertiary hospital. Targed OAAs analyzed were anaplastic lymphoma kinase inhibitors, BCR-ABL inhibitors, cyclin-dependent kinase inhibitors, epidermal growth factor receptor inhibitors, mTOR inhibitors, poly (ADP-ribose) polymerase inhibitors, and vascular endothelial growth factor receptor inhibitors. Patients were given a data collection form to record daily the number, severity (CTCAE version 5.0), and characteristics of stools during the first 30 days of treatment with OAAs. Multivariate analysis was performed to identify risk factors associated with the incidence of diarrhea.
Results
We analyzed 240 patients, of whom 28.7% experienced diarrhea (25.4% grades 1–2 and 3.3% grades 3–4). Patients treated with EGFR and VEGFR inhibitors had a higher incidence of diarrhea. The multivariate analysis revealed that taking the OAA with food was associated with a lower risk of diarrhea (OR = 0.404 0.205–0.956,
p
= 0.038).
Conclusions
More than a third of patients in treatment with OAAs presented diarrhea (any grade), and 22.1% of stools were semi-liquid/liquid. In multivariate analysis, taking the OAA on an empty stomach was associated with a statistically significant increase in the incidence of diarrhea.
INTRODUCTIONHLA sensitization is a growing problem in children awaiting kidney transplantation. In some cases, finding an immunologically compatible donor entails contemplating the option of an ABO ...incompatible transplant or paired transplant. METHODSPatient with genetic nephrotic syndrome and progressive chronic kidney disease, with a previous thrombosis of a first kidney transplant, resulting hypersensitized and remaining for a long-time on hemodialysis. Despite a desensitization strategy, family members were incompatible and deceased donation options must be ruled out due to the presentation of donor-specific antibodies (DSA). After 4 years, the possibility arises to perform a kidney paired transplant with a 62-year-old woman with an incompatible blood group. Although the current cytotoxicity- and cell-based crossmatches were negative, history of DSA were recorded. RESULTSAn intensive ABO and HLA desensitization protocol was performed in order to combat the isohemagglutinin antibodies and on the memory-HLA, based on rituximab, apheresis sessions, and immunoglobulins. Despite the donor being older in terms of pediatric transplantation, the donor-recipient weight difference, and immunological risk, the transplant was completed successfully. Maintenance of titration of up to 1/2 was confirmed after 3 weeks post-transplant (IgM and IgG). Kidney biopsy at 2 weeks and 6 months without signs of rejection. The patient is currently 12 months post-transplant and has not presented any signs of transplant rejection and has proper renal function. CONCLUSIONSKidney paired transplantation is an excellent solution for hypersensitized children, and ABO incompatibility can be considered to increase their options to find a good donor, without thereby obtaining worse results.
