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Cuidados de las zonas donantes de injertos de piel de espesor parcial. Umbrella review 局部厚度皮肤移植供体区域的护理。伞review
IF 0.5 Q4 NURSING Pub Date : 2023-11-01 DOI: 10.1016/j.enfcli.2023.10.001
Núria Babot-Pereña , Joan Blanco-Blanco

Objectives

To summarize the current evidence and develop recommendations on the most effective management of partial-thickness graft donor sites in adults to improve re-epithelialization, pain, and infection.

Methodology

Umbrella review. A systematic search of Pubmed, CUIDEN, Cochrane Library, CINHAL Plus, SCOPUS, and LILACS databases was conducted between October and December 2021, including systematic reviews published in the last 10 years that inquired about the effectiveness of any partial-thickness graft donor site healing strategy. Reviews with very low critical appraisal according to AMSTAR 2 were excluded. Included reviews were scored using the SIGN scale to determine their level of evidence and grade of recommendation.

Results

Five systematic reviews with meta-analysis were included. A statistically significant improvement in re-epithelialization and pain was observed in platelet-rich plasma and human amniotic membrane in relation to the control group. In addition, wound infection also decreased in platelet-rich plasma. A decrease in re-epithelialization time was also observed in recombinant human growth hormone.

Conclusions

The use of platelet-rich plasma is recommended to improve re-epithelialization, pain, and infection in partial-thickness graft donor sites in adults. The application of human amniotic membrane is recommended to accelerate re-epithelialization and reduce pain, and recombinant human growth hormone is recommended to accelerate the time to completely heal these wounds.

综合目前的证据,并为优化成人部分厚度移植物供体区(IPEP)的管理提供建议,以改善再上皮化,减少疼痛和预防感染。《伞》。对PubMed、CUIDEN、Cochrane Library、CINHAL Plus、SCOPUS和LILACS等数据库进行了系统搜索,重点是2011年以来发表的评估任何IPEP供体区域护理策略有效性的系统综述。被那些对信心水平很不小据方法MeaSurement Tool评估systematic反革命分子进行评价(2)。这些修订列入使用登录(苏格兰规模分析Intercollegiate指南网)以确定其证据(NE)和她的年级水平的建议。包括五个系统评价与分析(MA)。与对照组相比,使用富血小板血浆(PRP)或人羊膜(MAH)在再上皮化和疼痛缓解方面有统计学上显著的改善。此外,PRP也显示供体区域感染发生率降低。另一方面,重组人类生长激素的使用与再上皮化时间的减少有关。PRP推荐用于改善成人IPEP供体区域的再上皮化、减轻疼痛和预防感染。此外,建议使用MAH加速再上皮化和减少疼痛,并使用人类生长激素。总结目前的证据,并就最有效地管理成人部分厚度嫁接供体部位以改善再上皮化、疼痛和感染提出建议。《伞》。从2021年10月到12月,对Pubmed、CUIDEN、Cochrane Library、CINHAL Plus、SCOPUS和LILACS数据库进行了系统搜索,包括过去10年发表的系统评论,这些评论质疑了任何部分厚度石墨捐赠部位治疗策略的有效性。反革命with非常low critical评价根据评价2被排斥。= =地理= =根据美国人口普查局的数据,这个县的土地和(1.1%)水。= =地理= =根据美国人口普查,这个县的总面积是,其中土地和(5.064平方公里)水。与对照组相比,富血浆和人羊膜在再上皮化和疼痛方面有显著改善。此外,伤口感染也在富血小板血浆中减少。在重组人类生长激素中也观察到再上皮化时间的减少。建议使用富板血浆来改善成人部分厚度石墨供体部位的再上皮化、疼痛和感染。建议使用人类羊膜以加速再上皮化和减少疼痛,并建议重组人类生长激素以加快完全愈合这些伤口的时间。
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引用次数: 0
Redefiniendo la Atención Primaria a través de la mirada y actuación enfermera 通过护理的外观和表现重新定义初级保健
IF 0.5 Q4 NURSING Pub Date : 2023-11-01 DOI: 10.1016/j.enfcli.2023.09.003
Carmen Ferrer-Arnedo , Aintzane Orkaizagirre-Gómara
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引用次数: 0
Estado de salud de pacientes con trasplante hepático por enfermedad relacionada con el consumo de alcohol vs. otras etiologías: estudio de cohortes 酒精相关疾病与其他病因肝移植患者的健康状况:队列研究
IF 0.5 Q4 NURSING Pub Date : 2023-11-01 DOI: 10.1016/j.enfcli.2023.09.007
Victor Fernandez-Alonso , Ana Maria Hernandez-Matias , Manuela Perez-Gomez , Maria Nieves Moro-Tejedor

Aim

To study the health status of a group of patients with liver transplantation by alcohol-related disease vs another etiology before and after the transplantation.

Method

Longitudinal cohort study of liver transplant patients from November 2019 to July 2022. Adult patients attended in the unit of transplantation of a hospital for a first liver transplant, both elective and urgent, were included. Patients who already had a transplanted organ and those who required liver re-transplantation in the first month after the first transplant were excluded. Sociodemographic and clinical variables, MELDNa, liver frailty index, emotional-behavioral effects of transplantation, level of anxiety and depression were collected. Pearson's chi-square, Student's t, Mann-Whitney U, and Wilcoxon sign tests were used for statistical analysis.

Results

The sample was n = 67 liver transplant patients with a mean age of 56.37 years, 67.2% being men and 39% due to alcohol-related liver disease. 9% of all included patients were urgent transplants. Alcohol consumption was associated with older age, a high rate of liver frailty, and a non-active work situation. Alcoholic etiology correlated with increased concern during the first six months after liver transplantation.

Conclusion

There are differences in the health status between liver transplant patients for alcohol-related liver disease vs other etiology. Nurses must consider the etiology of liver disease to guide care and interventions throughout the transplant process.

目的:研究一组因酒精相关疾病而接受肝移植的患者在移植前后的健康状况与其他病因的关系。2019年11月至2022年7月肝移植患者纵向队列研究。我们纳入了在医院移植病房接受选择性和紧急第一次TH治疗的患者。我们排除了已经移植的患者和第一次移植后第一个月需要再移植的患者。收集社会人口学和临床变量、晚期肝病模型(MELDNa)、肝脆性指数(LFI)、移植的情绪行为影响、焦虑和抑郁水平。采用Pearson X2检验、学生t检验、Mann-Whitney U检验和Wilcoxon符号检验进行统计分析。本研究的目的是评估肝移植患者的肝移植情况,并评估肝移植患者的肝移植情况。本研究的目的是评估肝移植患者的肝移植情况。在所有纳入的患者中,9%是紧急移植。饮酒与年龄增长、肝脏脆性率高和不活跃的工作状况有关。在肝移植后的前6个月,酒精病因与更大的担忧相关。与其他病因相比,EHRA肝移植患者的健康状况存在差异。护士应考虑肝脏疾病的病因,以指导整个移植过程中的护理和干预。研究一组因酒精相关疾病而进行肝移植的患者在移植前后的健康状况与另一病因的比较。2019年11月至2022年7月肝移植患者纵向队列研究。包括在医院第一次肝移植移植单位接受选择性和紧急治疗的成人患者。已移植器官的患者和第一次移植后第一个月需要重新移植肝脏的患者不包括在内。收集了社会人口学和临床变量、MELDNa、肝脆弱指数、移植的情绪行为效应、焦虑和抑郁水平。= =地理= =根据美国人口普查,这个县的总面积为,其中土地和(1.5%)水。样本为67例肝移植患者,平均年龄56.37岁,67.2%为男性,39%为酒精相关肝病。9%的患者需要紧急移植。饮酒与年龄大、肝脏虚弱和不活跃的工作状况有关。酒精中毒的病因与肝移植后前6个月的担忧增加有关。酒精相关肝病的肝移植患者与其他病因的肝移植患者的健康状况存在差异。= =地理= =根据美国人口普查,这个县的面积为,其中土地面积为。
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引用次数: 0
Cuidados enfermeros en el duelo perinatal. Una revisión sistemática y crítica de las actitudes y los conocimientos en la práctica clínica 围产期决斗中的护理护士。临床实践中态度和知识的系统和批判性回顾
IF 0.5 Q4 NURSING Pub Date : 2023-09-01 DOI: 10.1016/j.enfcli.2023.06.004
Pablo Santiago Moreno-Tirado , Eugenia Gil-García , Lorena Tarriño-Concejero

Aim

To review and synthesize the available evidence on the attitudes and knowledge of nurses regarding the perinatal grief of the parents.

Methods

A systematic review of original articles published from January 2016 to February 2023 without language limit in the Scopus, PubMed, Cinahl, PsycINFO, ScienceDirect and Web Of Science databases was carried out. The PRISMA Statement methodological framework was used for systematic reviews and meta-analyses. The entire process was carried out in pairs, with discrepancies being resolved by a third reviewer. The quality of the articles was evaluated following the Critical Appraisal Skills Program Spanish (CASPe criteria).

Results

Twelve articles were obtained in this review after applying the inclusion criteria, of which. Except for one cross-sectional quantitative study (8.33%), the rest were qualitative studies carried out through interviews (75%) or discussion groups (16.66%). It is highlighted that there are different biopsychosocial problems related to the care needs demanded by the family and that, due to poor training or culture of the health professional, are not adequately addressed.

The studies found show various resources to adequately attend to perinatal grief, there being discrepancies in relation to allowing or not allowing the body of the deceased baby to be shown and/or taken; There are also disagreements regarding whether the healthcare team should base its practice on protocols or theories such as the Kübler-Ross theory of grief. Most of the studies (75%) consider that more training and awareness is necessary, contemplating the biopsychosocial nature of the user.

目的回顾和综合现有证据,了解护士对父母围产期悲伤的态度和知识。方法系统回顾2016年1月至2023年2月在Scopus、PubMed、Cinahl、PsycINFO、ScienceDirect和Web of Science数据库中发表的无语言限制的原创文章。采用PRISMA声明方法框架进行系统评价和荟萃分析。整个过程是成对进行的,差异由第三位审稿人解决。文章的质量根据西班牙语关键评估技能计划(CASPe标准)进行评估。结果应用纳入标准,共纳入12篇文献,其中;除一项横断面定量研究(8.33%)外,其余均为通过访谈(75%)或讨论组(16.66%)进行的定性研究。报告强调指出,与家庭所要求的护理需要有关的各种生物、心理和社会问题,由于保健专业人员的培训或文化不足,这些问题没有得到充分解决。研究发现,有各种资源可以充分照顾围产期悲伤,但在允许或不允许展示和/或带走死亡婴儿的尸体方面存在差异;关于医疗团队是否应该将其实践建立在协议或理论(如k勒-罗斯悲伤理论)的基础上,也存在分歧。大多数研究(75%)认为,考虑到用户的生物心理社会性质,需要更多的培训和意识。
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引用次数: 0
La transición posquirúrgica en adolescentes que padecen escoliosis idiopática. Un estudio cualitativo 特发性脊柱侧凸青少年的术后过渡。定性研究
IF 0.5 Q4 NURSING Pub Date : 2023-09-01 DOI: 10.1016/j.enfcli.2023.06.001
María Dolores Navarrete-Zampaña , Nicomedes Fernández-Baillo , Javier Pizones , José Miguel Sánchez-Márquez , María Carmen Sellán-Soto

Objective

To know the process experienced by adolescents suffering from idiopathic scoliosis when undergoing surgery to correct the physical deformity.

Method

Qualitative study with a symbolic interactionism approach. 22 semi-structured interviews were conducted with adolescents who underwent posterior spinal fusion in a third-level hospital in Madrid between May 2019 and January 2021. Taylor and Bogdan's analysis in progress was carried out.

Results

Patients with adolescent idiopathic scoliosis present with a complex simultaneous health/illness and developmental transition. The main inhibitory conditions of the transition are the meanings about: their identity, social, beliefs about surgery, ignorance about the pathology, the surgical process, and their recovery. As facilitating conditions, we find: a positive attitude towards physical, aesthetic, and social change, socioeconomic level, and family support.

Conclusions

The informants of this study refer that aesthetic affectation and physical limitations are the main elements that cause them discomfort. Surgical intervention is presented as the solution to this situation. Recovery is a critical point in the transition process mainly due to pain. They accept the discomfort suffered during the recovery because they hope to obtain an improvement in the image and physical limitations. The changes and differences they experience during the transition make them think that they will be able to lead a «normal life» to which they constantly refer in their speeches.

目的了解青少年特发性脊柱侧凸矫治手术的过程。方法采用符号交互作用的定性研究方法。2019年5月至2021年1月期间,对在马德里一家三级医院接受后路脊柱融合术的青少年进行了22次半结构化访谈。Taylor和Bogdan的分析正在进行中。结果青少年特发性脊柱侧凸患者同时存在复杂的健康/疾病和发育转变。这种转变的主要抑制条件是:他们的身份、社会、对手术的信念、对病理的无知、手术过程和他们的康复。作为促进条件,我们发现:对身体,审美和社会变化,社会经济水平和家庭支持的积极态度。结论审美的矫饰和身体的限制是造成她们不适的主要因素。手术干预被认为是解决这种情况的方法。恢复是过渡过程中的一个关键点,主要是由于疼痛。他们接受在康复过程中所遭受的不适,因为他们希望在形象和身体上得到改善。他们在过渡期间经历的变化和差异使他们认为自己能够过上他们在演讲中经常提到的“正常生活”。
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引用次数: 0
Experiencia de adultos mayores «PT4Ageing». Un programa de autogestión de enfermedades crónicas 老年人的“PT4ageing”体验。慢性病自我管理计划
IF 0.5 Q4 NURSING Pub Date : 2023-09-01 DOI: 10.1016/j.enfcli.2023.06.007
Célia Santos , Carla Silvia Fernandes , Celeste Bastos , Márcia Antonieta Cruz , Sandra Costa , Lígia Lima

Objective

This study sought to describe the experience of a group of older adults who participated in a chronic illness self-management programme.

Methods

The study employed a qualitative phenomenological approach. Participants were eight elders and data collected using semi-structured interviews. Data was analysed using thematic analysis.

Results

Five themes emerged from the analysis: 1) tips to improve our daily lives, 2) I was always motivated, 3) sharing and mutual help, 4) they made us believe we were capable, 5) It would be great if it did not end here. Globally, the participants of the programme described their experience as very positive. They identified gains from participating in the programme, such as learning strategies to help them cope with their health problems, improving their ability to manage their illnesses more autonomously and building social support, that even persisted after the conclusion of the intervention.

Conclusion

The findings of this study provide insight into how older adults experience a programme for the self-management of chronic illness. For the development of future programmes, support building must be considered. Older adults who participate in self-management programmes exhibit improved self-efficacy in relation to the management their chronic illnesses and greater autonomy in self-care.

目的:本研究旨在描述一组老年人参加慢性病自我管理计划的经历。方法采用定性现象学方法进行研究。参与者是8位老年人,数据通过半结构化访谈收集。数据采用专题分析进行分析。结果分析中出现了五个主题:1)改善我们日常生活的建议;2)我总是很有动力;3)分享和互助;4)他们让我们相信我们是有能力的;5)如果事情没有就此结束就好了。从全球来看,该方案的参与者将他们的经历描述为非常积极的。他们确定了参与该方案的好处,例如学习了帮助他们处理健康问题的策略,提高了他们更自主地管理疾病的能力,并建立了社会支持,甚至在干预结束后仍然存在。结论:本研究的发现为老年人如何体验慢性病自我管理方案提供了见解。为了制订今后的方案,必须考虑建立支助。参加自我管理计划的老年人在慢性病管理方面表现出更高的自我效能,在自我保健方面表现出更大的自主权。
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引用次数: 0
Explorando la validez de constructo del índice de Barthel en una muestra de pacientes hospitalizados españoles 探讨巴特尔指数在西班牙住院患者样本中的结构效度
IF 0.5 Q4 NURSING Pub Date : 2023-09-01 DOI: 10.1016/j.enfcli.2023.06.002
María Jesús Valero-Chillerón , Irene Llagostera-Reverter , David Luna-Aleixós , Mayte Moreno-Casbas , Laura Andreu-Pejó , Víctor M. González-Chordá

Objective

Examine the construct validity of the Barthel Index in adult inpatient units.

Methods

A secondary analysis was performed on a sample of 1342 adult patients admitted to inpatient units. A confirmatory factor analysis of the Barthel Index did not confirm its unidimensional structure (CFA-1). Therefore, two methods were explored to find a solution with a better fit. The sequence of the classical exploratory and confirmatory factor analysis methods was carried out (CFA-2). In contrast, a Gaussian graphical model and confirmatory factor analysis (CFA-3) were performed. Three models were compared on the basis of several goodness-of-fit indicators.

Results

CFA-1 results (χ2 = 161616; P < .001; RMSEA = .183) indicated a poor fit between the model and the data. Exploratory factor analysis provided a model with two dimensions that explained 86% of the variance and improved the goodness-of-fit in CFA-2 (χ2 = 846; P < .001; RMSEA = .133). The Gaussian graphical model, by removing the item ‘Bladder’, offered a solution with three dimensions that improved the goodness-of-fit compared to the previous models (χ2 = 492; P < .001; RMSEA = .09).

Conclusions

The Barthel Index is not a unidimensional measure of functional capacity when applied to adult inpatient units. The best-fitting model has a three-dimensional structure (Hygiene; Feeding and disposal; Mobility) that relates to the domains of care needs.

目的检验Barthel指数在成人住院部的结构效度。方法对1342例住院成人患者进行二次分析。Barthel指数的验证性因子分析并未证实其单维结构(CFA-1)。因此,我们探索了两种方法来寻找一个更适合的解决方案。采用经典探索性因子分析和验证性因子分析方法(CFA-2)进行排序。采用高斯图模型和验证性因子分析(CFA-3)进行对比。根据几个拟合优度指标对三种模型进行了比较。结果scfa -1结果(χ2 = 161616;P & lt;措施;RMSEA = .183)表明模型与数据的拟合较差。探索性因子分析提供了一个具有两个维度的模型,可以解释86%的方差,并提高了CFA-2的拟合优度(χ2 = 846;P & lt;措施;Rmsea = .133)。高斯图形模型通过去掉项目“膀胱”,提供了一个三维的解决方案,与以前的模型相比,该解决方案提高了拟合优度(χ2 = 492;P & lt;措施;Rmsea = .09)。结论Barthel指数不适用于成人住院病房功能能力的单维测量。最适合的模型具有三维结构(卫生学;饲养和处置;移动性),这与护理需求的领域有关。
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引用次数: 0
El entramado simbólico de la violencia obstétrica 产科暴力的象征框架
IF 0.5 Q4 NURSING Pub Date : 2023-09-01 DOI: 10.1016/j.enfcli.2023.06.003
Rosario Pérez García , Manuela Pérez García , Dolores Pérez García
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引用次数: 0
Valoración del liderazgo enfermero en un hospital del Sistema Sanitario Público Andaluz 安达卢西亚公共卫生系统医院护理领导能力评估
IF 0.5 Q4 NURSING Pub Date : 2023-09-01 DOI: 10.1016/j.enfcli.2023.06.005
Daniel Bárcenas-Villegas , María Soledad Vázquez-Santiago

Objective

To analyse, from a gender perspective, the characteristics and perception of the effects of leadership of nurses in a hospital of the Andalusian Public Health System.

Methodology

Qualitative study with a phenomenological approach. The participants were nurses in care and intermediate positions with a contract of more than 6 months. A qualitative content analysis was carried out. Four phases were established for data analysis, from which 5 categories resulted. NVivo 11 software was used to analyse the dialogues.

Results

The participants’ discourses endow the leader with characteristics that define him as a reference person. The contribution of middle management is necessary for the achievement of the objectives of the care units and the cohesion of the group, although this group perceives it only in relation to the management of resources. Access to management positions is not linked to gender.

Conclusions

The participants’ discourses endow the leader with characteristics that define him as a reference person. The contribution of middle management is necessary for the achievement of the objectives of the care units and the cohesion of the group, although this group perceives it only in relation to the management of resources. Access to management positions is not linked to gender.

目的从性别角度分析安达卢西亚公共卫生系统某医院护士领导的特点及效果感知。方法:用现象学方法进行定性研究。研究对象为实习期在6个月以上的护理及中级岗位的护士。进行了定性含量分析。数据分析建立了四个阶段,分为5类。采用NVivo 11软件对对话进行分析。结果参与者的话语赋予了领导者作为参考人的特征。中层管理人员的贡献对于实现护理单位的目标和群体的凝聚力是必要的,尽管这个群体只认为它与资源管理有关。获得管理职位的机会与性别无关。结论参与者的话语赋予了领导者作为参考人的特征。中层管理人员的贡献对于实现护理单位的目标和群体的凝聚力是必要的,尽管这个群体只认为它与资源管理有关。获得管理职位的机会与性别无关。
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引用次数: 0
Influencia de una intervención educativa en el conocimiento y en el manejo de la violencia de pareja por parte de enfermeras obstetras en Nigeria 教育干预对尼日利亚产科护士对伴侣暴力知识和管理的影响
IF 0.5 Q4 NURSING Pub Date : 2023-09-01 DOI: 10.1016/j.enfcli.2023.05.006
Theresa Olaitan Bamigboye , Omolola Oladunni Irinoye , Emmanuel Olufemi Ayandiran , Adekemi Eunice Olowokere , Opeyemi Adeniyi Adedeji , Deborah Tolulope Esan

Objective

To assess the influence of an educational intervention on midwives’ knowledge, detection and management of intimate partner violence (IPV).

Methods

A quasi-experimental study involving 158 midwives from two districts in Ekiti State, Nigeria. The sample was divided into experimental and control groups (79 midwives per group). Data were collected using a questionnaire and an observation checklist. A customized educational training program on IPV detection and management was conducted in the experimental group. Measurement was performed before the intervention, immediately after and 6 weeks later. Data were analyzed using descriptive and inferential statistics (Chi-square and binary logistic regression) with a level of significance set at P<.05.

Results

Prior knowledge regarding IPV detection and management among midwives in both groups was poor, with only 16.5% of the experimental group and 17.7% of the control group having good knowledge in the pre-intervention phase. The experimental group had a significant improvement in knowledge of IPV screening and management, with 82.1% having good knowledge immediately after the intervention and 92.0% at 6 weeks after the intervention (P=.001). Observed practice of IPV detection and management improved significantly from 21.9% satisfactory practice before the intervention to 63.5% after the intervention (P=.001) in the experimental group, with no appreciable improvement in practice detected in the control group (21.9 versus 36.5%; P=.682).

Conclusion

The use of a customized educational training program improved midwives’ knowledge and practice in the detection and management of intimate partner violence.

目的评估教育干预对助产士了解、发现和管理亲密伴侣暴力(IPV)的影响。方法对尼日利亚埃基提州两个地区的158名助产士进行准实验研究。将样本分为实验组和对照组(每组79名助产士)。使用问卷和观察检查表收集数据。在实验组中进行了关于IPV检测和管理的定制教育培训计划。在干预前、干预后立即和干预后6周进行测量。使用描述性和推断统计学(卡方和二元逻辑回归)分析数据,显著性水平设置为P<;。05.结果两组助产士对IPV检测和管理的先验知识较差,只有16.5%的实验组和17.7%的对照组在干预前阶段有良好的知识。实验组在IPV筛查和管理方面的知识有了显著提高,其中82.1%在干预后立即掌握良好知识,92.0%在干预后6周掌握良好知识(P=0.001)。实验组IPV检测和管理的观察实践从干预前的21.9%令人满意的实践显著改善到干预后的63.5%(P=.001),对照组在实践中没有发现明显的改善(21.9%对36.5%;P=.682)。结论使用定制的教育培训计划提高了助产士在发现和管理亲密伴侣暴力方面的知识和实践。
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引用次数: 0
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Enfermeria Clinica
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