Precisión de las características definitorias del diagnóstico de enfermería termorregulación ineficaz en recién nacidos

ObjectiveTo identify the measures of accuracy for defining characteristics of the nursing diagnosis: Ineffective thermoregulation in newborns.MethodDiagnostic accuracy study with cross-sectional design performed in medium and high-risk maternity units, located in Fortaleza city/Brazil. A total of 216 newborns were evaluated to identify the defining characteristics of the diagnosis under study. The measures of accuracy for defining characteristics were obtained from a latent class model with random effects for the calculation of sensitivity and specificity values.ResultsThe characteristics of increased respiratory rate and warm skin to the touch had higher sensitivity values (99.9%) and lower specificity (79 and 75%) and the characteristics of body temperature fluctuations above and below the normal parameters and hypertension had the highest specificity (80.4 and 100%, respectively).ConclusionThe characteristic fluctuation of the body temperature above and below the normal parameters may be better to confirm the diagnosis, having presented a higher specificity value.     

Lifestyle intervention to prevent gestational diabetes mellitus and adverse maternal outcomes among pregnant women at high risk for gestational diabetes mellitus

ObjectiveWe assessed the effects of a lifestyle intervention on gestational diabetes mellitus (GDM) incidence and risk of adverse maternal outcomes among pregnant women at high risk for GDM.MethodsFrom July to December 2018, we enrolled 1822 eligible pregnant women; of these, 304 had at least one risk factor for GDM. Participants were randomly allocated to the intervention or control group. Usual prenatal care was offered to both groups; the intervention group also received individually modified education on diet, physical activity, and weight control. The GDM diagnosis was based on an oral glucose tolerance test at 24–28 gestational weeks. Multivariate logistic regression was used to evaluate the effects of the lifestyle intervention on risk of GDM and adverse maternal outcomes.ResultsA total of 281 women (139 in the intervention group and 142 controls) were included. Incidences of GDM and adverse maternal outcomes were all significantly lower in the intervention than in the control group. Multivariate logistic regression indicated that women in the intervention group had a lower risk of GDM and adverse maternal outcomes, after adjusting potential confounding factors.ConclusionThe present lifestyle intervention was associated with lower risks of GDM and adverse maternal outcomes.     

The association of plant-based dietary patterns with visceral adiposity,lipid accumulation product,and triglyceride-glucose index in Iranian adults

BackgroundWe sought to investigate whether adherence to a more plant-based, and less animal-based, diet is associated with visceral adiposity, lipid accumulation product (LAP), and triglyceride-glucose index (TyG) in Iranian adults.MethodsThis cross-sectional study was conducted on 270 adults aged between 18–75 years old. We created three plant-based diets. including an overall plant-based diet index (PDI), hPDI, and uPDI based on tertiles regarding the intake of animal- or plant-based food items obtained from a semi quantitative food-frequency questionnaire.ResultsHigher hPDI was significantly associated with lower body mass index (BMI) (P-value = 0.01), lower waist circumference (P-value<0.001), and lower waist-hip ratio (P-value<0.001). A significant increase was found for high density lipoproteins (HDL) (P-trend <0.001) with a significant decrease for LAP (P-value = 0.03) in those with higher adherence to hPDI. Moreover, greater adherence to PDI was associated with a significant increase in diastolic blood pressure (DBP) (p-value = 0.01) and fat free mass (FFM) (p-value = 0.01). There were no significant associations between PDIs and TyG and VFA.ConclusionWe found that a higher hPDI score was significantly associated with better anthropometric measurements. A significant increase was found for HDL and a significant decrease was found for LAP on hPDI. However, a higher PDI score was significantly associated with higher DBP and higher FFM.     

神经性厌食症患者进食障碍与家庭功能关系的研究

目的 探讨神经性厌食症(AN)患者进食障碍及其与家庭功能的关系.方法 使用进食障碍调查量表(EDI),家庭功能量表(FAD)对29例AN患者的进食障碍及其家庭功能进行评定,对其身高体重指数(BMI)进行计算,并与大学生样本进行对照研究.结果 AN患者EDI对瘦的追求,贪食,对身体不满意,无效感,完美主义,对他人不信任,...     

静态水气分离器分离效率试验研究

目的 评估某型静态水气分离器的分离效率.方法 采用自行设计搭建的重力条件下地面试验系统,对水气分离器分离效率的评价方法进行了研究,针对激光颗粒测试仪监测法精度不足的问题,提出了重量测试法.采用重量测试法考查了水滴直径、重力以及工作时间等因素对水气分离器分离效率的影响.结果 在气体流量为150 L/min,水流量为120...     

冠状动脉CT成像钙化积分扫描噪声与增强扫描噪声的相关性分析

目的：分析冠状动脉CT血管成像（CCTA）中对比增强前后图像噪声值的关系,探讨一种预测CTCA图像噪声的方法,从而为实施个体化剂量管理提供依据。方法：回顾性分析固定各扫描序列曝光参数的82例64层螺旋CT回顾性门控冠状动脉CTA的图像资料,研究钙化积分扫描（CACS）图像噪声（SD1）与对比增强扫描图像噪声（SD2）之间的线性相关性,以及体重指数（BMI）与对比增强扫描图像噪声（SD2）之间的线性相关性,并拟合出直线方程。结果：SD1与SD2之间直线相关系数r=0.94（P〈0.0001）,线性方程为SD2=1.29624×SD1＋1.20457;BMI与SD2之间的直线相关系数r=0.80（P〈0.0001）,线性方程为SD2=1.56067×BMI-10.76970。结论：在CTA各序列的曝光参数不变的情况下,对比增强前后图像噪声值之间存在高度线性相关性。钙化积分扫描噪声比体重指数能更精确地预测增强扫描图像的噪声,从而使基于钙化积分扫描噪声的个体化剂量控制成为可能。     

巨大儿相关因素及对妊娠结局影响的探讨

目的探讨巨大儿发生的相关因素及妊娠结局。方法选择足月出生的巨大儿320例,同时随机选择同期出生的足月正常体质量儿200例作为对照,分析产妇的年龄、身高、孕产次、孕前体质量指数(BMI)、孕期体质量增长、母婴并发症、剖宫产率等。结果巨大儿母亲的平均身高、孕期体质量增长及母婴并发症、剖宫产率显著高于对照组(P<0.05)。结论预防巨大儿的发生有利于改善母婴结局。     

Bariatric surgery

Obesity is a progressive disease that shortens life expectancy and is associated with a wide range of medical problems ranging from diabetes and heart disease through to infertility and cancer. Losing weight can significantly improve or cure these conditions and helps to reduce the chances of future health problems developing. Anti-obesity drugs result in a 10% fall in body weight, but this degree of weight loss has never been shown to confer significant clinical benefit in patients with a body mass index exceeding 40 kg/m², for whom bariatric surgery is indicated. Gastric banding is less effective than other procedures and it takes longer for target weight loss to be reached, but it is the safest, quickest and least expensive bariatric procedure. Gastric bypass is a more effective option, as weight loss is more rapid and is generally complete within a year. However, the drawback is that the bypass carries more risk. It also induces a mild degree of malabsorption, and affects satiety signalling between the gut and brain. The duodenal switch (DS) shares some features with the gastric bypass in that both operations prevent calorie absorption, although this effect is much more marked after a DS. The advantage of this approach is that excellent, reliable weight loss can be achieved without the need to reduce the stomach (and thus portion) size dramatically. However, patients need to adhere to a strict high-protein diet with vitamin supplementation if nutritional problems are to be avoided.     

Kinematics of medial osteoarthritic knees before and after posterior cruciate ligament retaining total knee arthroplasty

Total knee arthroplasty (TKA) is a widely accepted surgical procedure for the treatment of patients with end‐stage osteoarthritis (OA). However, the function of the knee is not always fully recovered after TKA. We used a dual fluoroscopic imaging system to evaluate the in vivo kinematics of the knee with medial compartment OA before and after a posterior cruciate ligament‐retaining TKA (PCR‐TKA) during weight‐bearing knee flexion, and compared the results to those of normal knees. The OA knees displayed similar internal/external tibial rotation to normal knees. However, the OA knees had less overall posterior femoral translation relative to the tibia between 0° and 105° flexion and more varus knee rotation between 0° and 45° flexion, than in the normal knees. Additionally, in the OA knees the femur was located more medially than in the normal knees, particularly between 30° and 60° flexion. After PCR‐TKA, the knee kinematics were not restored to normal. The overall internal tibial rotation and posterior femoral translation between 0° and 105° knee flexion were dramatically reduced. Additionally, PCR‐TKA introduced an abnormal anterior femoral translation during early knee flexion, and the femur was located lateral to the tibia throughout weight‐bearing flexion. The data help understand the biomechanical functions of the knee with medial compartment OA before and after contemporary PCR‐TKA. They may also be useful for improvement of future prostheses designs and surgical techniques in treatment of knees with end‐stage OA. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:40–46, 2011