Plan de cuidados individualizado de paciente con pie diabético

Mediante el desarrollo de este trabajo se pretende dar a conocer la magnitud de un problema como es la Diabetes Mellitus y sus complicaciones, especificando en este caso una de las complicaciones más importante como es el Pie Diabético. Se quiere destacar la importancia de la prevención en el Pie Diabético aportando datos sobre las complicaciones que puedan surgir. Para minimizarlas sería esencial aplicar un protocolo de prevención adecuado, dentro de una unidad multidisciplinar, donde la enfermería adquiere un papel fundamental, garantizando una continuidad de cuidados de la persona afectada. Se plantea un plan de atención de enfermería individualizado de un paciente con pie diabético a través de la taxonomía NANDA-NOC-NIC. El sistema de valoración utilizado es el diseñado por Marjory Gordon en los años 70, ya que cumple todos los requisitos necesarios para la realización de una valoración enfermera eficaz, por lo que constituye una herramienta útil para la valoración con cualquier modelo disciplinar enfermero. Define once patrones de actuación relevantes para la salud. Se trata de comportamientos, más o menos comunes a todas las personas, que contribuyen a su salud, calidad de vida y al logro de su potencial humano.

Mechanisms of Toxicity of Ag Nanoparticles in Comparison to Bulk and Ionic Ag on Mussel Hemocytes and Gill Cells

Silver nanoparticles (Ag NPs) are increasingly used in many products and are expected to end up in the aquatic environment. Mussels have been proposed as marine model species to evaluate NP toxicity in vitro. The objective of this work was to assess the mechanisms of toxicity of Ag NPs on mussel hemocytes and gill cells, in comparison to ionic and bulk Ag. Firstly, cytotoxicity of commercial and maltose stabilized Ag NPs was screened in parallel with the ionic and bulk forms at a wide range of concentrations in isolated mussel cells using cell viability assays. Toxicity of maltose alone was also tested. LC50 values were calculated and the most toxic Ag NPs tested were selected for a second step where sublethal concentrations of each Ag form were tested using a wide array of mechanistic tests in both cell types. Maltose-stabilized Ag NPs showed size-dependent cytotoxicity, smaller (20 nm) NPs being more toxic than larger (40 and 100 nm) NPs. Maltose alone provoked minor effects on cell viability. Ionic Ag was the most cytotoxic Ag form tested whereas bulk Ag showed similar cytotoxicity to the commercial Ag NPs. Main mechanisms of action of Ag NPs involved oxidative stress and genotoxicity in the two cell types, activation of lysosomal AcP activity, disruption of actin cytoskeleton and stimulation of phagocytosis in hemocytes and increase of MXR transport activity and inhibition of Na-K-ATPase in gill cells. Similar effects were observed after exposure to ionic and bulk Ag in the two cell types, although generally effects were more marked for the ionic form. In conclusion, results suggest that most observed responses were due at least in part to dissolved Ag.