Articles publicats en revistes (Infermeria Fonamental i Clínica)

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Higher eating frequency is associated with lower adiposity and robust circadian rhythms: a cross-sectional study
(Elsevier B.V., 2021) Zerón-Rugerio, María Fernanda; Díez Noguera, Antoni; Izquierdo Pulido, Maria; Cambras Riu, Trinitat
Background Although overweight and obesity are assumed to arise from an energy imbalance, evidence has shown that the frequency and timing of meals are also potential risk factors for obesity. However, the lack of a consistent approach to define eating patterns relative to internal circadian rhythms limits the extent of these findings. Objectives The objective of this study was to investigate the association of the circadian pattern of energy intake with adiposity and with internal circadian rhythms. Methods A total of 260 Spanish adults (aged 20-30 y; 78.1% women) were included in a 6-d cross-sectional study. Participants documented sleep and dietary intake within the study period. From these data, we evaluated the chronotype, eating patterns (meal timing, eating duration, and eating frequency), and we obtained the daily profile of energy intake. In addition, we evaluated the circadian pattern of wrist temperature (internal circadian rhythm marker). Circadian patterns of energy intake and wrist temperature were analyzed, and their association among them and with anthropometric variables and diet quality was studied. Results The greater fragmentation of the circadian pattern of energy intake was associated with lower BMI (in kg/m2; −10.55; 95% CI: −16.96, −4.13; P = 0.001). In addition, a greater eating frequency (≥5 eating occasions/d) was significantly associated with lower BMI (−1.88; 95% CI: −3.27, −0.48) and higher energy intake after 20:00 (4.14% of kcal; 95% CI: 1.67, 7.16). Furthermore, a greater eating frequency was associated with lower fragmentation (P = 0.042) and greater stability of the circadian pattern of wrist temperature (P = 0.016). Conclusions The daily pattern of energy intake is associated with adiposity and robust circadian rhythms. Our results shed light on the relevance of eating frequency as a potential zeitgeber for the circadian system. Although more evidence is needed, eating frequency could be considered for future chrono-nutritional recommendations for the prevention of circadian misalignment and obesity.
Doctoral education in nursing in ibero-america: an analysis of its evolution and perspectives for the future
(John Wiley & Sons, 2025-12-07) Guedes dos Santos, José Luís; Rodríguez‐López, Javier Isidro; Ortiz‐Anaya, Yalena; Aponte Franco, Sandra Milena; Rodríguez-Martín, Dolors; Galbany Estragués, Paola; Pimenta Lopes Ribeiro, Olga Maria; Oliveira Amaral, Thayza Mirela; Lorenzini Erdmann, Alacoque; Squires, Allison P.
Aim: To provide an overview of doctoral programs in nursing offered in Ibero-American countries to inform regional collaboration and academic development. Design: This study was a descriptive, document analysis. Methods: A systematic mapping was conducted using data obtained from official university and program websites, national postgraduate databases, and academic documents. The variables analysed included country, institution, year of implementation, number of faculty and students, course duration, delivery modality, costs, scholarship availability, internationalisation activities, and research lines. Results: A total of 94 active nursing doctoral programs were identified. Brazil emerged as the pioneer, launching the first doctoral program in 1982, and remains the regional leader, accounting for 43 programs. Most programs are offered by public institutions (76.6%), delivered primarily in face-to-face format (64.1%), and emphasise research (90.4%). There has been a consistent upward trend in the establishment of programs since 2000, with notable expansion between 2011 and 2025. Despite this progress, regional disparities persist, along with a lack of data standardisation and a limited presence of professional doctorates. While 69.1% of programs reported international activities, few offer joint or dual degrees. The most common thematic axis, “Health Care and Nursing,” proved to be broad and non-specific. Conclusion: The study reveals the expanding landscape of nursing doctoral education in Ibero-America, while also exposing persistent challenges regarding access, curricular clarity and regional articulation. Implications for the Profession and/or Patient Care: Doctoral programs are essential for developing research capacity, academic leadership and evidence-based care. Strengthening these programs could enhance nursing responses to local health needs and promote scientific progress in care delivery. Impact: This study provides the first comprehensive mapping of nursing doctoral programs in Ibero-America, highlighting regional disparities and areas for academic collaboration, with potential impact on policy-making, curriculum development, and the strengthening of research capacity in nursing education. Reporting Method: STROBE (Strengthening the Reporting of Observational Studies in Epidemiology). Patient or Public Involvement: No patient or public contribution.
Insights into the 2025 ESC guidelines for the management of cardiovascular disease and pregnancy
(Elsevier España, 2025-11-25) Bravo Amaro, Marisol; Sitges Carreño, Marta; Mirabet Pérez, Sonia; Avanzas, Pablo; Mazón, Pilar; De la Torre, José M.; Crespo, Marisa; Sanchis Forés, Juan; Vivas, David; Andrea, Rut; Martínez Momblán, Ma. Antonia; Cordero Fort, Alberto; Torres Llergo, Javier; Jiménez Candil, F. Javier
The 2025 ESC guidelines for the management of cardiovascular disease and pregnancy1 address the need for an updated review of the previous recommendations. A special effort has been made to provide clear information, supported by summary tables, graphical abstracts, and flow charts that enhance clinical applicability. Cardiovascular disease (CVD) is now the leading cause of nonobstetric mortality in pregnant women,2 with a rising incidence of acquired heart disease.
Insights into the 2025 ESC guidelines for the management of myocarditis and pericarditis
(Elsevier España, 2025-11-25) De la Torre, José M.; Torres Llergo, Javier; Vivas, David; Avanzas, Pablo; Mazón, Pilar; Andrea, Rut; Bravo Amaro, Marisol; Cordero Fort, Alberto; Crespo, Marisa; Jiménez Candil, F. Javier; Martínez Momblán, Ma. Antonia; Mirabet, Sonia; Sanchis Forés, Juan; Sitges Carreño, Marta
These are the first European Society of Cardiology (ESC) integrated guidelines on myocarditis and pericarditis,1 recognizing their shared etiopathogenic basis and introducing the new concept of inflammatory myopericardial syndrome (IMPS). This umbrella term reflects the close interplay and frequent overlap between the two conditions in clinical practice (figure 1).
Satisfaction in the Intensive Care Unit (ICU). Patient opinion as a cornerstone
(Elsevier España, 2017-03-01) HU-CI Project; Romero García, Marta; Holanda Peña, María Soledad; Talledo, N. Marina; Ots Ruiz, Elsa; Lanza Gómez, José Manuel; Ruiz Ruiz, Ana; García Miguelez, Ana; Gómez Marcos, Vanesa; Domínguez Artiga, María José; Hernández Hernández, Miguel Ángel; Vallmann, Reinhard; Llorca Diaz, Javier Francisco
Objective: To study the agreement between the level of satisfaction of patients and their families referred to the care and attention received during admission to the ICU. Design: A prospective, 5-month observational and descriptive study was carried out. Setting: ICU of Marqués de Valdecilla University Hospital, Santander (Spain). Subjects: Adult patients with an ICU stay longer than 24 h, who were discharged to the ward during the period of the study, and their relatives. Intervention: Instrument: FS-ICU 34 for assessing family satisfaction, and an adaptation of the FS-ICU 34 for patients. The Cohen kappa index was calculated to assess agreement between answers. Results: An analysis was made of the questionnaires from one same family unit, obtaining 148 pairs of surveys (296 questionnaires). The kappa index ranged between 0.278 and 0.558, which is indicative of mild to moderate agreement. Conclusions: The families of patients admitted to the ICU cannot be regarded as good proxies, at least for competent patients. In such cases, we must refer to these patients in order to obtain first hand information on their feelings, perceptions and experiences during admission to the ICU. Only when patients are unable to actively participate in the care process should their relatives be consulted.
Estudi de la satisfacció dels estudiants d'infermeria sobre els entorns d'aprenentatge clínic mitjançant una eina d'intel·ligència artificial
(ICE Universitat de Barcelona, 2025-12-09) Martí-Ejarque, María del Mar; Alonso-Fernández, Sergio; Puente López, Ariadna; Pijoan Lara, Clara; Cantero Cano, Montserrat; Cordero Luque, Verónica; Martínez Momblán, Ma. Antonia
INTRODUCCIÓ. Per analitzar la qualitat docent dels entorns d’aprenentatge clínic s’estudia la satisfacció de l’alumnat, utilitzant escales que fan una avaluació quantitativa i objectiva. Analitzar els comentaris dels estudiants pot ajudar a comprendre millor les raons de la qualificació numèrica. MÈTODE. Estudi transversal descriptiu fet en un hospital universitari entre octubre del 2020 i juliol del 2024. Per a l’anàlisi es va utilitzar el programa Kh Coder, una eina que analitza textos i estudia la correlació de les paraules que contenen. Hi van participar 431 estudiants d’infermeria, que van contestar un qüestionari en línia amb una escala d’avaluació d’entorns d’aprenentatge clínic i una pregunta oberta perquè poguessin fer qualsevol comentari en relació amb la seva experiència durant les pràctiques. RESULTATS. Es van donar 187 respostes a la pregunta oberta, de les quals es van analitzar un total de 327 oracions. Dels resultats de l’anàlisi van emergir els temes principals següents: reconeixement a la tasca de la tutora, sensació de sentir-se integrat i repercussió de les càrregues de treball. DISCUSSIÓ. Els resultats obtinguts segueixen la línia d’estudis ja publicats i porten a plantejar actuacions en tres àrees específiques: capacitació docent, estabilització de plantilles i gestió de les càrregues de treball.
Reflexiones sobre el consenso ESC 2025 sobre la enfermedad mental y la enfermedad cardiovascular
(Elsevier España, 2025-11-12) Bravo Amaro, Marisol; Sitges Carreño, Marta; Mirabet Pérez, Sonia; Avanzas, Pablo; Mazón, Pilar; De la Torre, José M.; Crespo, Marisa; Sanchis, Juan; Vivas, David; Andrea, Rut; Martínez Momblán, Ma. Antonia; Cordero Fort, Alberto; Torres Llergo, Javier; Jiménez Candil, F. Javier
This clinical consensus statement emphasizes the bilateral relationship between cardiovascular disease (CVD) and mental health (MH), as has been demonstrated in certain clinical scenarios, taking into account the lack of evidence to guide clinical practice. This working group has adopted a Delphi process in which experts in CVD and MH have expressed their opinions on those evidence-poor points. An ordinal Likert scale was used (strongly agree, agree, neither agree nor disagree, disagree, strongly disagree, reject), and finally only those recommendations in which at least 75% of experts had “agree” or “strongly agree” were considered. As a result of this analysis and the gathered scientific evidence, a total of thirty-four recommendations were published in this document.
Plan de cuidados en un paciente con insuficiencia renal crónica
(Sociedad Española de Enfermería Nefrológica, 2000-01-01) Romero García, Marta
A continuación presentamos el caso de un paciente con Insuficiencia Renal Crónica durante su ingreso hospitalario en la Unidad de Cuidados Intensivos del Hospital de la Santa Creu i Sant Pau de Barcelona, teniendo en cuenta el modelo de Virginia Henderson. Este modelo nos habla del rol autónomo y del rol de colaboración. Dentro del rol autónomo se realiza suplencia de autonomía y se completan las áreas de dependencia (fuerza, voluntad y conocimientos) para que el paciente logre su independencia. Encontramos diagnósticos enfermeros reales o de riesgo. Dentro del rol de colaboración encontramos problemas de colaboración o interdependientes derivados del diagnóstico y tratamiento médico. La recogida de datos se realiza el segundo día de ingreso, lo que nos permite identificar problemas y valorarlos para marcarnos unos objetivos que tendrán validez hasta el plazo marcado y planificaremos intervenciones. De esta manera cuando llegue la fecha marcada se evaluará el cumplimiento de dicho objetivo o si por el contrario necesitamos unos nuevos para resolver dichos problemas.
Effectiveness of closed blood-sampling devices in critically Ill adults: A feasibility trial
(Wiley, 2026-01-16) Zaragoza-García, Ignacio; Raurell Torredà, Marta; Arias-Rivera, Susana; Fernández-Castillo, Rafael-Jesús; Frade Mera, María Jesús; González-Caro, María-Dolores; Andreu-Vázquez, Cristina; Muriel-García, Alfonso; Grupo Ahorro-Sangre (Blood-Sparing Research Group)
Background: Anaemia in critically ill patients is often worsened by diagnostic blood sampling. Closed blood sampling devices(CBSDs) may reduce iatrogenic blood loss and transfusion needs. However, robust evidence of their effectiveness and feasibilityin the intensive care unit (ICU) setting is lacking.Aim: To assess the feasibility of conducting a multicentre randomised controlled trial (RCT) evaluating the effectiveness ofCBSDs in reducing transfusion requirements in critically ill adults.Study Design: A two-centre, open-label, feasibility RCT was conducted in two Spanish university hospitals between November2024 and March 2025. Patients with an ICU stay of 24 h who were expected to have an arterial catheter for at least 72 h longerwere randomised to either a CBSD group (intervention) or standard practice (control). Primary outcome was feasibility (recruitmentrate, intervention fidelity and dropout). Secondary outcomes included transfusion rates, discard volume and catheter-relatedadverse events. Data were collected over a maximum of 21 days or until ICU discharge or catheter removal. As this was afeasibility study with a small sample size, no statistical inference analyses were performed.Results: Of 678 patients screened, 9.3% (n = 63) were eligible, and of those eligible, 76.2% (n = 48) were enrolled. After exclusionsand losses, 31 patients were analysed (12 intervention, 19 control). Low eligibility was mainly due to short catheter dwell timesand advanced monitoring needs with a Flotrac system. Intervention fidelity was suboptimal in four patients in the interventiongroup because one of the ICUs routinely used a venous route for blood gas sampling, despite patients having the CBSD in anarterial line. Thirteen patients (27.1%) were lost to follow-up for the same reasons as the low eligibility findings. There were nomissing data (0%). Transfusion rates per 100 catheter days were lower in the intervention group (5.2 vs. 15.6). Discard volume per100 catheter days was substantially reduced (53.1 mL vs. 970.7 mL). No catheter-related bacteraemias occurred.Conclusions: A full-scale RCT evaluating CBSDs in ICU patients is feasible with protocol modifications, including broader siteparticipation and improved device integration with advanced monitoring systems. Preliminary data suggest that CBSDs mayreduce transfusion requirements and blood loss in critically ill patients.Relevance to Clinical Practice: Nurses’ involvement in the prevention of iatrogenic anaemia is key. CBSDs appear to be afeasible strategy for reducing blood loss associated with blood tests, with preliminary results linking their use to a decrease inthe need for transfusions. If this is confirmed in the final clinical trial, it would mean greater safety for patients by avoidingcomplications linked to transfusions and would contribute to environmental sustainability by reducing the production of carbondioxide associated with the process of collecting, storing and distributing red blood cells.
Satisfacció i Cultura Organitzativa als Entorns d'Aprenentatge Clínic d'Infermeria: Una Revisió Integrativa
(Asociación para el Desarrollo del Practicum y de las Prácticas Externas: Red de Practicum (REPPE), 2025-12-30) Martí-Ejarque, María del Mar; Martínez Momblán, Ma. Antonia; Cuzco, Cecilia; Alonso-Fernández, Sergio
El estudio tiene como objetivo identificar las características de los entornos de aprendizaje clínico de los estudiantes de enfermería. El método consiste en una revisión bibliográfica según el modelo de Whittemore Knafl Se incluyeron artículos publicados entre 2010 y 2020 que analizaban entornos de aprendizaje clínico enfermero mediante herramientas validadas y/o estudiaran la satisfacción de los agentes implicados en el aprendizaje. Se seleccionaron 44 estudios. Se identificaron aspectos del entorno de aprendizaje clínico, tanto a nivel institucional,macroentorno, como a nivel de unidad ,microentorno, y los agentes implicados en el proceso de aprendizaje. Entre los resultados se encontró que existe una visión fragmentada de los entornos, ya que los estudios se centran en aspectos aislados del contexto o de sus agentes. Tras su análisis, se observó que la relación entre los distintos niveles organizativos, desde la dirección hasta el personal clínico, se manifiesta como un elemento clave para el éxito del aprendizaje, al facilitar una cultura colaborativa que potencia la docencia y la integración del estudiante en el entorno clínico.
Contingency plan for the intensive care services for the COVID-19 pandemic
(Elsevier España, 2020-09-01) Martín Delgado, María Cruz; Martínez Estalella, Gemma; Raimondi, Nicolás; Roca i Gas, Oriol; Rodríguez Oviedo, Alejandro; Romero San Pío, Emilia; Trenado Álvarez, José; Junta directiva de la SEMICYUC; Junta directiva de la SEEIUC; Rascado Sedes, Pedro; Ballesteros Sanz, María de los Ángeles; Bodi Saera, Maria Amparo; Carrasco Rodríguez-Rey, Luis Fernando; Castellanos Ortega, Álvaro;; Catalán González, Miguel; Haro López, Candelaria de; Díaz Santos, Emili; Escribá Bárcena, Almudena; Frade Mera, María Jesús; Igeño Cano, José Carlos
In January 2020, the Chinese authorities identified a new virus of the Coronaviridae family as the cause of several cases of pneumonia of unknown aetiology. The outbreak was initially confined to Wuhan City, but then spread outside Chinese borders. On 31 January 2020, the first case was declared in Spain. On 11 March 2020, The World Health Organization (WHO) declared the coronavirus outbreak a pandemic. On 16 March 2020, there were 139 countries affected. In this situation, the Scientific Societies SEMICYUC and SEEIUC have decided to draw up this Contingency Plan to guide the response of the Intensive Care Services. The objectives of this plan are to estimate the magnitude of the problem and identify the necessary human and material resources. This is to provide the Spanish Intensive Medicine Services with a tool to programme optimal response strategies.
Comentarios a la actualización 2023 de la guía ESC 2021 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica
(Elsevier España, 2024-04-01) Bayes-Genis, Antoni; Nuñez Villota, Julio; Recio Mayoral, Alejandro; Delgado, Juan; Cobo, Marta; Martínez Momblán, Ma. Antonia ; Gómez-Otero, Inés; Calero Molina, Esther
La Sociedad Europea de Cardiología (ESC) publicó su actualización1 para incluir nuevas recomendaciones basadas en la evidencia científica aparecida después de la última guía sobre la insuficiencia cardiaca (IC) de 2021 y hasta el 31 de marzo de 20232. Es de destacar que solo se han incorporado los datos que afectan a recomendaciones de clase I o IIa, y que están relacionados con los objetivos principales de ensayos clínicos, en su mayor parte hospitalización por IC o muerte de causa cardiovascular. Esta actualización está justificada principalmente por el beneficio aportado por los inhibidores del cotransportador de sodio-glucosa 2 (iSGLT2) en los pacientes con fracción de eyección del ventrículo izquierdo (FEVI) levemente reducida (ICFElr) o conservada (ICFEc), así como en los pacientes hospitalizados por IC. El resto de los cambios sobre todo refuerzan o elevan la clasificación de las recomendaciones previas, excepto por la novedad de la finerenona, un nuevo antagonista selectivo de receptores de mineralocorticoides (ARM) (figura 1).
Impact of a nurse-driven patient empowerment intervention on the reduction in patients' anxiety and depression during intensive care unit discharge: a randomized clinical trial
(Lippincott, Williams & Wilkins, 2022-09-30) Cuzco, Cecilia; Castro Rebollo, Pedro; Marín Pérez, Raquel; Ruiz García, Samuel; Núñez Delgado, Ana Isabel; Romero García, Marta; Martínez Momblán, Ma. Antonia; Benito-Aracil, Llúcia; Carmona Delgado, Inmaculada; Canalias Reverter, Montse; Nicolás, José M.; Martínez Estalella, Gemma; Delgado-Hito, Pilar
Objectives: To assess the impact of a nurse-driven patient empowerment intervention on anxiety and depression of patients during ICU discharge. Design: A prospective, multicenter, randomized clinical trial. Setting: Three ICUs (1 medical, 1 medical and surgical, and 1 coronary) of three tertiary hospitals. Patients: Adults admitted to the ICU greater than 18 years old for greater than or equal to 48 hours with preserved consciousness, the ability to communicate and without delirium, who were randomized to receive the nurse-driven patient empowerment intervention (NEI) (intervention group [IG] or standard of care [control group (CG)] before ICU discharge. Intervention: The NEI consisted of an individualized intervention with written information booklets, combined with verbal information, mainly about the ICU process and transition to the ward, aimed at empowering patients in the transition process from the ICU to the general ward. Measurements and results: Patients completed the Hospital Anxiety and Depression Scale before and after (up to 1 wk) ICU discharge. IG (n = 91) and CG (n = 87) patients had similar baseline characteristics. The NEI was associated with a significant reduction in anxiety and depression (p < 0.001) and the presence of depression (p = 0.006). Patients with comorbidities and those without family or friends had greater reductions in anxiety and depression after the NEI. After the intervention, women and persons with higher education levels had lower negative outcomes. Conclusions: We found that a NEI before ICU discharge can decrease anxiety and depression in critically ill survivors. The long-term effect of this intervention should be assessed in future trials.
The clinical learning environment, supervision and nurse teacher scale: Psychometric testing of the catalan version
(2025-04-25) Martí-Ejarque, María del Mar; Martínez Momblán, Ma. Antonia; Strandell-Laine, Camilla; Romero García, Marta; Benito-Aracil, Llúcia; Alonso-Fernández, Sergio
Background and Purpose: The clinical learning environment is the space in which nursing students develop their professional skills. The Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) scale makes it possible to assess its quality. This study aimed to develop the psychometric testing of the newly translated Catalan version of the CLES+T. Methods: The translation process was carried out according to the principles of good practice of the International Society for Pharmacoeconomics and Outcomes Research Working Group. The students completed the Catalan version of the CLES+T, and 15 days later, they took part in the temporal stability test. Results: The internal consistency was .934, and the interclass correlation coefficient of the re-test was .865. The exploratory factor analysis showed five dimensions. Conclusion: The Catalan version of the CLES+T scale is a valid and reliable tool to assess the quality of clinical learning environments in Catalonia.
SimCapture for Skills®: Mobile-based web skills training for undergraduate nursing students: A randomized clinical trial
(Elsevier, 2025-01-17) Raurell Torredà, Marta; Obejo-Alamillos, Carmen; Turégano-Daso, Concepción; Esteban-Sepúlveda, Silvia; Adalid, Roser; Estrada Masllorens, Joan Maria; Sarria Guerrero, José Antonio; Basco Prado, Luis; Zaragoza-García, Ignacio; Fernández Cervilla, Ana Belén
Background: Emerging mobile-based technologies offer self-learning teaching strategies for technical skills training. Methods: In a randomized clinical trial with nursing students, all participants received traditional classroom and SimCapture-assisted training. Checklist scores for self-assessment, satisfaction and self- confidence were compared for each learning scenario. Costs were also compared. Results: In the traditional training session self-assessments, scores were higher when students received the traditional training after SimCapture than before it (75 [67.6–76] vs 73 [61.4–76], p = .006, d = 0.54). Satisfaction and self-confidence were higher with SimCapture. Training with SimCapture saved 12538 euros compared to traditional classroom training. Conclusions: SimCapture for Skills®is an effective and financially feasible instruction method.
Comments on the 2023 ESC guidelines on cardiovascular disease in patients with diabetes
(Elsevier España, 2024-03-10) Campuzano, Raquel; Mazón, Pilar; Castro Conde, Almudena; Cid Álvarez, Ana Belén; Cruzado Álvarez, Concepción; Díez Villanueva, Pablo; Fernández Olmo, Rosa; Freixa Pamias, Román; Marzal Martin, Domingo; Mirabet Pérez, Sonia; Ferreiro, José Luis; Avanzas, Pablo; Andrea, Rut; Boraita, Araceli; Calvo, David; Campuzano Ruiz, Raquel; Delgado, Victoria; Dos Subirá, Laura; Gómez-Doblas, Juan José; Martínez Momblán, Ma. Antonia; Mazón, Pilar; Pascual Figa, Domingo; Sanchis, Juan; De la Torre Hernández, José María; Vivas, David
The new guidelines of the European Society of Cardiology (ESC) 2023 for the management of patients with cardiovascular (CV) disease (CVD) and diabetes incorporate a central figure that focuses on the presentation of a patient with diabetes and CVD: first case: a patient with CVD that includes atherosclerotic cardiovascular disease (ASCVD), atrial fibrillation (AF) and heart failure (HF), in whom diabetes screening must be performed; second case, a patient with diabetes in whom CVD or chronic kidney disease (CKD) must be ruled out. In the first case, there are no changes for the diagnosis of diabetes using the already known diagnostic criteria1: a) fasting plasma glucose ≥ 126mg/dL; b) glycated hemoglobin (HbA1c) ≥ 6.5%; c) plasma glucose 2hours after an oral glucose overload test (75g) ≥ 200mg/dL; and d) plasma glucose ≥ 200mg/dL in patients with classic symptoms of hyperglycemia or a hyperglycemic crisis. In the second case, CVD screening is recommended based on the patient's symptoms and electrocardiogram (ECG). The document does not introduce peptides in this screening, or imaging tests, or detection of ischemia in asymptomatic patients with diabetes.
Insights into the 2025 ESC/EACTS guidelines on the management of patients with valvular heart disease
(Elsevier España, 2025-11-28) De la Torre, José M.; Torres Llergo, Javier; Vivas, David; Avanzas, Pablo; Mazón, Pilar; Andrea, Rut; Bravo Amaro, Marisol; Cordero Fort, Alberto; Crespo, Marisa; Jiménez Candil, F. Javier; Martínez Momblán, Ma. Antonia; Mirabet, Sonia; Sanchis Forés, Juan; Sitges Carreño, Marta
The 2025 Practice Guidelines on the management of patients with valvular heart disease of the European Society of Cardiology (ESC) and the European Association of Cardio-Thoracic Surgery include new and updated recommendations based on the evidence provided by several landmark randomized clinical trials and large multicentre registries (1). How these new recommendations may apply to and impact on current clinical practice in Spain will be discussed in this commentary.
Association of sex and age and delay predictors on the time of primary angioplasty activation for myocardial infarction patients in an emergency department
(Elsevier, 2023-03-11) Berga Congost, Gemma; Martínez Momblán, Ma. Antonia ; Valverde Bernal, Jonatan; Marquez Lopez, Adrian; Ruiz Gabalda, Judit; Garcia Picart, Joan; Puig Campmany, Mireia; Brugaletta, Salvatore
Background: : Time between Emergency Department (ED) and ST-segment elevation acute myocardial infarction (STEMI) activation time is a good indicator of ED quality. STEMI delays are of particular importance in some subgroups, such as women and the elderly. Objective: : To determine the association of sex and age with activation time in STEMI patients admitted to the ED. Methods: : An observational retrospective study was conducted including all patients admitted to the ED activated as a STEMI. The main variable was activation time. To evaluate the independent predictors of activation time, a multivariate logistic regression analysis was carried out, variables were sex, age, sex and age combined, chest pain, ST elevation in the electrocardiogram, and first medical contact (FMC) at the hospital’s ED. Results: : A total of 330 patients were included. They were classified by sex: 23.9% (78) women and 76.1% (249) men; and age: 51.1% (167) <65 yo and 48.9% (160) 65 yo. Women and elderly patients exhibited a more atypical presentation. Multivariate analysis shows that showed that elderly age (OR=1.976 95%; CI=1.2573.104; p = 0.003) and FMC prior to attending the ED (OR=1.762; 95% CI=1.1172.779; p = 0.015) were associated with a longer activation time. Women older than 65 years old showed the longest activation time. Conclusion: : STEMI delays are longer in women and the elderly with atypical presentation. Age 65 and FMC outside the ED were associated with an increase in the activation time. This highlights the need to develop strategies to improve activation time for these specific patient groups.
Care complexity factors and discharge destination in an emergency department: A retrospective cohort study
(Shahid Beheshti University of Medical Sciences, 2025-01-18) Urbina, Andrea; Adamuz Tomas, Jordi; Juvé Udina, Eulàlia; Peñafiel, Judith; Munoa-Urruticoechea, Virginia; González Samartino, Maribel; Delgado-Hito, Pilar; Jacob, Javier; Romero García, Marta
Introduction: Emergency department discharge destination is an important topic in both clinical practice and management.This study aimed to analyze the association of Care Complexity Individual Factors (CCIFs) with discharge destinations in patients who visit the emergency department (ED). Methods: This is a retrospective cohort study with consecutive sampling, including all patients who visited the ED of a tertiary hospital during 2021-2022. Data were collected from electronic health records. The main study outcomes were discharge destinations (mortality, intensive care unit admission, hospitalization, left without being seen/discharge against medical advice, and home discharge) and 26 CCIFs. Independent multinomial logistic regression was used for assessing the association of each factor and the discharge destinations, adjusted for age, sex, and triage level. All analyses were performed with R, version 4.3.2. Results: A total of 35,383 patients were included. Of these, 60.8% were home discharged, 34.1% were hospitalized, 2.6% were transferred to the intensive care unit, 2.1% were left without being seen, and 0.4% died. The presence of CCIFs was a risk factor of ED mortality (odds ratio (OR): 13.49 [95% confidence interval (CI): 4.99;36.46]), intensive care unit admission (OR:1.26 [95%CI:1.08;1.47]), and hospitalization (OR: 1.62 [95%CI:1.53;1.71]), whilst the presence of care complexity factors was a protective factor of discharge against medical advice (OR:0.64 [95%CI:0.55;0.74]). Conclusion: The discharge destinations from the ED showed strong associations with the patient’s complexity factors. Health professionals should consider these relationships for the design of early detection strategies and as an aid in decision-making, to ensure equity and quality of care.
Principales demandas informativas de los familiares de pacientes ingresados en Unidades de Cuidados Intensivos
(Elsevier España, 2018-08-01) Velasco Bueno, José Manuel; Alonso-Ovies, Ángela; Heras-La Calle, Gabriel; Zaforteza Lallemand, Concha; Equipo de investigación del Proyecto HUCI (Humanizando los Cuidados Intensivos)
Objetivo Elaborar un catálogo de demandas informativas priorizadas por los familiares, conocer qué profesionales consideran estos que pueden responder a estas demandas y explorar las diferencias de criterio entre familiares y profesionales. Diseño Análisis cualitativo de validación de contenido; estudio descriptivo transversal. Ámbito Cuarenta y una UCI españolas. Participantes Familiares, médicos y enfermeras/os de pacientes críticos. Intervención De un listado inicial de preguntas extraído de revisión de la literatura, médicos, enfermeras/os y familiares de pacientes críticos incorporaron cuestiones que consideraron no incluidas. Tras análisis de validación de contenido, se obtuvo un nuevo listado que fue valorado nuevamente por los participantes para determinar el nivel de importancia que asignaban a cada pregunta y qué profesional consideraban adecuado para responderla. Resultados Cuestiones más importantes para los familiares: preocupación por la situación clínica, medidas a tomar, pronóstico e información. Existió coincidencia entre familiares y profesionales en las cuestiones prioritarias para las familias. Existieron diferencias significativas en la importancia dada a cada pregunta: entre médicos y familiares (72/82 preguntas) y entre enfermeras/os y familiares (66/82 cuestiones) (p< 0,05). Para los familiares, el 63% de las preguntas podrían ser contestadas por médicos o enfermeras/os indistintamente, el 27% preferentemente por los médicos y 10% por las enfermeras/os. Conclusiones Las cuestiones más relevantes para las familias fueron pronóstico y gravedad, pero también la necesidad de información. Los profesionales sanitarios tendemos a subestimar la importancia de muchas de las cuestiones que preocupan a las familias. Los familiares consideran que la mayoría de sus inquietudes pueden ser resueltas indistintamente por médicos o enfermeras/os.

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