Eduardo Osuna - Academia.edu (original) (raw)

Papers by Eduardo Osuna

Revista de estudios extremeños, 2001

Healthcare

To date, the impact of the COVID-19 pandemic on the world’s health, economics and politics is sti... more To date, the impact of the COVID-19 pandemic on the world’s health, economics and politics is still heavy, and efforts to mitigate virus transmission have caused remarkable disruption. From the early onset of the pandemic, generated by SARS-CoV-2 spread, the scientific community was aware of its impact on vulnerable individuals, including pregnant women. The purpose of this paper is to highlight scientific pitfalls and ethical dilemmas emerging from management of severe respiratory distress in pregnant women in order to add evidence to this topic through an ethical debate. In the here-presented paper, three cases of severe respiratory syndrome are analyzed. No specific therapeutic protocol was available to guide physicians in a cost–benefit balance, and unequivocal conduct was not a priori suggested from scientific evidence. However, vaccines’ advent, viral variants lurking on the horizon and other possible pandemic challenges make it necessary to maximize the experience gained thro...

In order to assess mental health status, and the classification of both the overreporting and und... more In order to assess mental health status, and the classification of both the overreporting and underreporting scales and indexes, 102 psychiatric prison inmates deemed mentally incompetent to stand trial completed the Spanish adaptation of the MMPI-2 under standard instructions (honest responding). The results showed patterns of consistent, non-random, nor extremely acquiescent responses. Moreover, no-outlier responses were detected. In line with the psychiatric diagnosis, all the psychiatric prison inmates were classified by the basic clinical scales as clinical cases of the psychotic dyad i.e., schizophrenia and paranoid ideation. The overreporting scales and indexes (i.e., F, K, Fb, F-K, Fp, Ds and FBS) classified the participants as malingerers, whereas the L, Wsd, and Od underreporting scales as good feigners. These scales assessing impression management i.e., consciously faking good biased responses, did not classify overreporters. Thus, they are robust indicators of honest res...

Se realizo un estudio descriptivo transversal retrospectivo, durante el periodo de agosto del 200... more Se realizo un estudio descriptivo transversal retrospectivo, durante el periodo de agosto del 2004 a agosto del 2008 en el Hospital Neurologico de la Fundacion Instituto para la Rehabilitacion de personas con Epilepsia (FIRE) y la Liga Colombiana contra la Epilepsia (LCCE) en la ciudad de Cartagena.

Objectives-To analyse theattitudes ofmedical personnel towards terminally ill patients andtheir r... more Objectives-To analyse theattitudes ofmedical personnel towards terminally ill patients andtheir right tobefully informed. Design-Self-administered questionnaire composed of56closed questions. Setting-Three general hospitals andeleven health centres inGranada (Spain). Thesample comprised 168doctors and207nurses. Results-A high percentage ofmedical personnel (24. 1%)donotthink that informing theterminally ill would help themface their illness with greater serenity. Eighty-four percentthink thepatient's own homeisthebest place todie: 8.9%ofthesubjects questioned state that they would notlike tobe informed ofanincurable illness. Conclusion-In ouropinion anyinformation given should depend onthepatient's personality, thestage oftheillness andfamily circumstances. Ourstudy confirms that ahospital isnottheideal environment forattending totheneeds oftheterminally ill and their families. (7ournal ofMedical Ethics 1998;24:106-109)

Revista Espanola De Drogodependencias, 2013

Revista De Estudios Extremenos, 2010

espanolLa Secretaria Gestora del Plan de Badajoz tenia entre sus funciones la difusion de los ben... more espanolLa Secretaria Gestora del Plan de Badajoz tenia entre sus funciones la difusion de los beneficios de la realizacion del Plan. Para llevar a cabo su labor, empleo todos los medios a su alcance: publicaciones, radio, cine television, exposiciones y certamenes. La difusion del Plan fue un escaparate de la propaganda franquista de cara al interior y el exterior del pais. EnglishThe anaging Secretariat of the Plan Badajoz had between his functions the diffusion of the benefits of the accomplishment of the Plan. To carry out his labor it used all the means to his scope: publications, radio, cinema, television, exhibitions and contests. The diffusion of the Plan was a shop window of the proFranco propaganda so much in the interior as the exterior of the country.

Cuadernos De Bioetica, 2006

Information is one of the key pillars on which the doctor-patient relationship is founded. In Nov... more Information is one of the key pillars on which the doctor-patient relationship is founded. In November 2002, Spanish law 41/2002 set out the basis for patient autonomy and the right to information, and the obligation to provide clinical information and documentation, describing important aspects of the information process and the informed consent of the patient. In this article, we analyze the right to information in a legal framework and look at some points that remain unclear. The patient's right to information, even when linked to the prior giving of informed consent, is an autonomous and independent right. The provision of information as an integral part of the new clinical model based on interactive and communicative precepts, contributes, like any other part of the care provision process, to improving the quality of health care.

Journal of Fertilization: In vitro, 2012

Medicine and law, 2010

One of the pillars of healthcare provision is respect for the autonomy of the patient's wishe... more One of the pillars of healthcare provision is respect for the autonomy of the patient's wishes, which is given substance by the process of obtaining informed consent. Minors deserve special protection, entitled to basic rights and increasingly autonomous as they develop. In certain situations, minors are deemed matures and able to consent to treatment without the involvement of a parent or guardian. The assessment of competence would be based on the child's functional ability, not on age or outcome of the decision. This manuscript includes a brief analysis of legal perspectives on informed consent of minors, and minors' capacities to make medical decisions. Remaining questions of how to evaluate capacity and balance parental and minor autonomy are explored. Considerations on informed consent in different situations as refusing treatment and termination of pregnancy by female children are analyzed.

Medicine and law, 2009

The doctor-patient relationship has undergone important changes in recent years. Increasing level... more The doctor-patient relationship has undergone important changes in recent years. Increasing levels of distrust, on the part of patients towards professionals and institutions, have led to an increase of conflicts resulting in violent actions against health service personnel. The aim of this study is to analyse this phenomenon in the public welfare services of the Region of Murcia (Spain), based on an analysis of accusations, as were presented by doctors in courts in the period between 2006 and April 2008. The conclusion reached can presumably be extrapolated to the rest of Spain. The violent reactions in question resulted from patients demanding drug prescriptions; the prolongation of sick leave and the demand for diagnostic tests. The Public Health Services provide directives to anticipate and avoid such situations, emphasize the training of professionals in communication skills, the promotion of skills of negotiation and emotional self-control. Other measures include the installat...

Bulletin of Environmental Contamination and Toxicology, 1995

Organoehlorine compounds are widely employed and exist as residues in the environment. Some of th... more Organoehlorine compounds are widely employed and exist as residues in the environment. Some of the r are carcinogenic while others are not, even though they exhibit positive responses in short-term mutagenic assays. The main structural features affecting the carcinogenicity of organochlorine compounds are still unknown. Up to now, there is no effective way to predict whether or not organochlorine compounds are carcinogenic. ha this report, the genotoxicity of 41 organochlorine compounds are studied using discriminant analysis. We examined the experimental results of the Salmonella assay (Ames Test), and the cercinogenicity of these compounds to the mouse. Discdminant functions relating to the genotoxicity of organochlorine compounds were established based on molecular descriptors. MATERIALS AND METHODS The 41 compounds studied (Table 1), include chlorinated hydrocarbons, chlorinated aromatics and some pesticides, etc., which are extensively used. None ofthe 41 compounds contain amino or nitro groups. The mutagenicity and carcinogenicity data were taken from the U.S. National Toxicology Program (Ashby et al., 1991). Three kinds of genetoxieity indices were examined, the first involving the Salmonella assay (SA), the second, mouse liver carcinogenicity (CL), and the third, whole mouse carcinogenicity (CW) (tumors at all tissue sites). The three genotoxicity indices involving the 41 coml~unds are given in Table l. The compounds with positive effects were

Diagnostics, 2021

In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the ... more In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the circumstances of death. Several studies propose either the pericardial fluid or peripheral veins as a location for troponin determination, but the optimum sampling site is still a matter of debate. Our objective was to evaluate the association between the ratio of troponin values in the pericardial fluid and serum (determined postmortem) and the diagnosis of acute myocardial infarction (AMI) in the context of sudden cardiac death. We included 175 forensic cases. Two groups were established: AMI deaths (48; 27.4%) and the control group (127; 72.6%). The cardiac Troponin I (cTnI) values in the pericardial fluid and the troponin ratio were found to be associated with the cause of death. Univar...

Journal of Forensic and Legal Medicine, 2021

Drug-facilitated sexual assault (DFSA) and drug-facilitated crime (DFC) constitute a mode of viol... more Drug-facilitated sexual assault (DFSA) and drug-facilitated crime (DFC) constitute a mode of violence that is generally unknown to the population and may go unnoticed by health professionals. The aim of this systematic review was to analyze the victims of DFC, compiling their sociodemographic characteristics, the toxic substances used and their biological matrices and modes of action, in order to identify the substances that are commonly put to criminal use. The aim would be to establish political and health strategies that inform and warn people about possible criminal social behaviors consequent danger to health. This systematic review was conducted following the PRISMA guidelines. Alcohol, benzodiazepines and cocaine were among the most commonly detected substances. In most of the hospitals, immunoassays, liquid chromatography (LC-MS), or gas chromatography-mass spectrometry (GC-MS) analyses were used to identify the substances, while the most frequently used biological matrices were blood and urine. From a judicial point of view, the instrumental protocols and techniques followed for the detection of toxics in different biological matrices must guarantee the reliability and validity of the results for use in a court of law. The recommendations of international organizations should be followed and must be called upon to strengthen their respective national laws against this chemical submission (CS) phenomenon.

Diagnostics, 2020

Drowning is one of the leading causes of death worldwide. The pathophysiology of drowning is comp... more Drowning is one of the leading causes of death worldwide. The pathophysiology of drowning is complex and, sometimes, interpretation of the circumstances of death in the autopsy becomes the main source of information in its diagnosis. New advances in medical research, such as proteomics, especially in forensic pathology, are still in the development. We proposed to investigate the application of Mass Spectrometry-based technologies, to identify differentially expressed proteins that may act as potential biomarkers in the postmortem diagnosis of drowning. We performed a pilot proteomic experiment with the inclusion of two drowned and two control forensic cases. After applying restrictive parameters, we identified apolipoprotein A1 (ApoA1) and α-1 antitrypsin as differentially expressed between the two diagnostic groups. A validation experiment, with the determination of both proteins in 25 forensic cases (16 drowned and 9 controls) was performed, and we corroborated ApoA1 higher value...

Journal of Public Health Research, 2018

The healthcare professional plays a key role in the detection and subsequent channeling of a situ... more The healthcare professional plays a key role in the detection and subsequent channeling of a situation of violence to a judicial level for appropriate investigation. The mandatory reporting of gender violence has become a controversial issue among health care practitioners and victims. The objective of this study was to analyze the quality of the way in which injury reports on victims of gender violence is completed, through an analysis of the information they include, the readability and the degree to which the document can be understood. A retrospective study in a sample of 197 injury reports were performed from health services (primary care, hospital services and emergency services). We analyzed 22 variables related to the content, readability of the document, the victim's identification data as well as identification of the doctor responsible for assistance, the moment of assistance and the characteristics of the injury. The most frequent deficiencies in the data are identif...

Journal of Public Health Research, 2018

The information process is considered a core element in decision- making and an obligatory matter... more The information process is considered a core element in decision- making and an obligatory matter of concern for the health professional. Rather than information per se, we should perhaps mention the need for communication between the health professional and the patient, which should be appropriate to each specific case and situation. Interaction and communication during the relationship generates a degree of trust that contributes to improving care quality and health-related results. The aim of this study is to know the perception of professionals on the quality of communication and its impact on the decision-making process of the patient and the degree of involvement of health professionals in the process of communication with the patient. A sample of 2186 health professionals (1578 nurses, 586 physicians, and 22 pharmacists) was studied. A questionnaire composed of 20 items dealing with the process of communication with the patient and obtaining informed consent was administered....

Archives of Medical Science, 2018

IntroductionThe Child-Pugh and model for end-stage liver disease (MELD) scores are widely used to... more IntroductionThe Child-Pugh and model for end-stage liver disease (MELD) scores are widely used to predict the outcomes of liver transplant (LT). Both have similar prognostic values in most cases, although their benefits might differ in some specific conditions. The aim of our study was to analyze the influence of pre-transplant ascites and encephalopathy in post-transplant liver rejection development and survival in alcohol cirrhosis (AC) patients undergoing LT to determine the usefulness of the Child-Pugh score for the assessment of prognosis in such patients.Material and methodsTwo hundred and eighty-one AC patients, classified according to viral infections and pre-transplant complications, were analyzed. Acute (AR) and chronic (CR) liver rejections and Child-Pugh, MELD and albumin-bilirubin (ALBI) scores were studied in all cases.ResultsSimilar AC rejection percentages were observed in ascites or encephalopathy groups (18.5% and 16.5%, p = 0.735), although a higher but not statis...

Journal of Forensic Sciences, 1989

Revista de estudios extremeños, 2001

Healthcare

To date, the impact of the COVID-19 pandemic on the world’s health, economics and politics is sti... more To date, the impact of the COVID-19 pandemic on the world’s health, economics and politics is still heavy, and efforts to mitigate virus transmission have caused remarkable disruption. From the early onset of the pandemic, generated by SARS-CoV-2 spread, the scientific community was aware of its impact on vulnerable individuals, including pregnant women. The purpose of this paper is to highlight scientific pitfalls and ethical dilemmas emerging from management of severe respiratory distress in pregnant women in order to add evidence to this topic through an ethical debate. In the here-presented paper, three cases of severe respiratory syndrome are analyzed. No specific therapeutic protocol was available to guide physicians in a cost–benefit balance, and unequivocal conduct was not a priori suggested from scientific evidence. However, vaccines’ advent, viral variants lurking on the horizon and other possible pandemic challenges make it necessary to maximize the experience gained thro...

In order to assess mental health status, and the classification of both the overreporting and und... more In order to assess mental health status, and the classification of both the overreporting and underreporting scales and indexes, 102 psychiatric prison inmates deemed mentally incompetent to stand trial completed the Spanish adaptation of the MMPI-2 under standard instructions (honest responding). The results showed patterns of consistent, non-random, nor extremely acquiescent responses. Moreover, no-outlier responses were detected. In line with the psychiatric diagnosis, all the psychiatric prison inmates were classified by the basic clinical scales as clinical cases of the psychotic dyad i.e., schizophrenia and paranoid ideation. The overreporting scales and indexes (i.e., F, K, Fb, F-K, Fp, Ds and FBS) classified the participants as malingerers, whereas the L, Wsd, and Od underreporting scales as good feigners. These scales assessing impression management i.e., consciously faking good biased responses, did not classify overreporters. Thus, they are robust indicators of honest res...

Se realizo un estudio descriptivo transversal retrospectivo, durante el periodo de agosto del 200... more Se realizo un estudio descriptivo transversal retrospectivo, durante el periodo de agosto del 2004 a agosto del 2008 en el Hospital Neurologico de la Fundacion Instituto para la Rehabilitacion de personas con Epilepsia (FIRE) y la Liga Colombiana contra la Epilepsia (LCCE) en la ciudad de Cartagena.

Objectives-To analyse theattitudes ofmedical personnel towards terminally ill patients andtheir r... more Objectives-To analyse theattitudes ofmedical personnel towards terminally ill patients andtheir right tobefully informed. Design-Self-administered questionnaire composed of56closed questions. Setting-Three general hospitals andeleven health centres inGranada (Spain). Thesample comprised 168doctors and207nurses. Results-A high percentage ofmedical personnel (24. 1%)donotthink that informing theterminally ill would help themface their illness with greater serenity. Eighty-four percentthink thepatient's own homeisthebest place todie: 8.9%ofthesubjects questioned state that they would notlike tobe informed ofanincurable illness. Conclusion-In ouropinion anyinformation given should depend onthepatient's personality, thestage oftheillness andfamily circumstances. Ourstudy confirms that ahospital isnottheideal environment forattending totheneeds oftheterminally ill and their families. (7ournal ofMedical Ethics 1998;24:106-109)

Revista Espanola De Drogodependencias, 2013

Revista De Estudios Extremenos, 2010

espanolLa Secretaria Gestora del Plan de Badajoz tenia entre sus funciones la difusion de los ben... more espanolLa Secretaria Gestora del Plan de Badajoz tenia entre sus funciones la difusion de los beneficios de la realizacion del Plan. Para llevar a cabo su labor, empleo todos los medios a su alcance: publicaciones, radio, cine television, exposiciones y certamenes. La difusion del Plan fue un escaparate de la propaganda franquista de cara al interior y el exterior del pais. EnglishThe anaging Secretariat of the Plan Badajoz had between his functions the diffusion of the benefits of the accomplishment of the Plan. To carry out his labor it used all the means to his scope: publications, radio, cinema, television, exhibitions and contests. The diffusion of the Plan was a shop window of the proFranco propaganda so much in the interior as the exterior of the country.

Cuadernos De Bioetica, 2006

Information is one of the key pillars on which the doctor-patient relationship is founded. In Nov... more Information is one of the key pillars on which the doctor-patient relationship is founded. In November 2002, Spanish law 41/2002 set out the basis for patient autonomy and the right to information, and the obligation to provide clinical information and documentation, describing important aspects of the information process and the informed consent of the patient. In this article, we analyze the right to information in a legal framework and look at some points that remain unclear. The patient's right to information, even when linked to the prior giving of informed consent, is an autonomous and independent right. The provision of information as an integral part of the new clinical model based on interactive and communicative precepts, contributes, like any other part of the care provision process, to improving the quality of health care.

Journal of Fertilization: In vitro, 2012

Medicine and law, 2010

One of the pillars of healthcare provision is respect for the autonomy of the patient's wishe... more One of the pillars of healthcare provision is respect for the autonomy of the patient's wishes, which is given substance by the process of obtaining informed consent. Minors deserve special protection, entitled to basic rights and increasingly autonomous as they develop. In certain situations, minors are deemed matures and able to consent to treatment without the involvement of a parent or guardian. The assessment of competence would be based on the child's functional ability, not on age or outcome of the decision. This manuscript includes a brief analysis of legal perspectives on informed consent of minors, and minors' capacities to make medical decisions. Remaining questions of how to evaluate capacity and balance parental and minor autonomy are explored. Considerations on informed consent in different situations as refusing treatment and termination of pregnancy by female children are analyzed.

Medicine and law, 2009

The doctor-patient relationship has undergone important changes in recent years. Increasing level... more The doctor-patient relationship has undergone important changes in recent years. Increasing levels of distrust, on the part of patients towards professionals and institutions, have led to an increase of conflicts resulting in violent actions against health service personnel. The aim of this study is to analyse this phenomenon in the public welfare services of the Region of Murcia (Spain), based on an analysis of accusations, as were presented by doctors in courts in the period between 2006 and April 2008. The conclusion reached can presumably be extrapolated to the rest of Spain. The violent reactions in question resulted from patients demanding drug prescriptions; the prolongation of sick leave and the demand for diagnostic tests. The Public Health Services provide directives to anticipate and avoid such situations, emphasize the training of professionals in communication skills, the promotion of skills of negotiation and emotional self-control. Other measures include the installat...

Bulletin of Environmental Contamination and Toxicology, 1995

Organoehlorine compounds are widely employed and exist as residues in the environment. Some of th... more Organoehlorine compounds are widely employed and exist as residues in the environment. Some of the r are carcinogenic while others are not, even though they exhibit positive responses in short-term mutagenic assays. The main structural features affecting the carcinogenicity of organochlorine compounds are still unknown. Up to now, there is no effective way to predict whether or not organochlorine compounds are carcinogenic. ha this report, the genotoxicity of 41 organochlorine compounds are studied using discriminant analysis. We examined the experimental results of the Salmonella assay (Ames Test), and the cercinogenicity of these compounds to the mouse. Discdminant functions relating to the genotoxicity of organochlorine compounds were established based on molecular descriptors. MATERIALS AND METHODS The 41 compounds studied (Table 1), include chlorinated hydrocarbons, chlorinated aromatics and some pesticides, etc., which are extensively used. None ofthe 41 compounds contain amino or nitro groups. The mutagenicity and carcinogenicity data were taken from the U.S. National Toxicology Program (Ashby et al., 1991). Three kinds of genetoxieity indices were examined, the first involving the Salmonella assay (SA), the second, mouse liver carcinogenicity (CL), and the third, whole mouse carcinogenicity (CW) (tumors at all tissue sites). The three genotoxicity indices involving the 41 coml~unds are given in Table l. The compounds with positive effects were

Diagnostics, 2021

In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the ... more In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the circumstances of death. Several studies propose either the pericardial fluid or peripheral veins as a location for troponin determination, but the optimum sampling site is still a matter of debate. Our objective was to evaluate the association between the ratio of troponin values in the pericardial fluid and serum (determined postmortem) and the diagnosis of acute myocardial infarction (AMI) in the context of sudden cardiac death. We included 175 forensic cases. Two groups were established: AMI deaths (48; 27.4%) and the control group (127; 72.6%). The cardiac Troponin I (cTnI) values in the pericardial fluid and the troponin ratio were found to be associated with the cause of death. Univar...

Journal of Forensic and Legal Medicine, 2021

Drug-facilitated sexual assault (DFSA) and drug-facilitated crime (DFC) constitute a mode of viol... more Drug-facilitated sexual assault (DFSA) and drug-facilitated crime (DFC) constitute a mode of violence that is generally unknown to the population and may go unnoticed by health professionals. The aim of this systematic review was to analyze the victims of DFC, compiling their sociodemographic characteristics, the toxic substances used and their biological matrices and modes of action, in order to identify the substances that are commonly put to criminal use. The aim would be to establish political and health strategies that inform and warn people about possible criminal social behaviors consequent danger to health. This systematic review was conducted following the PRISMA guidelines. Alcohol, benzodiazepines and cocaine were among the most commonly detected substances. In most of the hospitals, immunoassays, liquid chromatography (LC-MS), or gas chromatography-mass spectrometry (GC-MS) analyses were used to identify the substances, while the most frequently used biological matrices were blood and urine. From a judicial point of view, the instrumental protocols and techniques followed for the detection of toxics in different biological matrices must guarantee the reliability and validity of the results for use in a court of law. The recommendations of international organizations should be followed and must be called upon to strengthen their respective national laws against this chemical submission (CS) phenomenon.

Diagnostics, 2020

Drowning is one of the leading causes of death worldwide. The pathophysiology of drowning is comp... more Drowning is one of the leading causes of death worldwide. The pathophysiology of drowning is complex and, sometimes, interpretation of the circumstances of death in the autopsy becomes the main source of information in its diagnosis. New advances in medical research, such as proteomics, especially in forensic pathology, are still in the development. We proposed to investigate the application of Mass Spectrometry-based technologies, to identify differentially expressed proteins that may act as potential biomarkers in the postmortem diagnosis of drowning. We performed a pilot proteomic experiment with the inclusion of two drowned and two control forensic cases. After applying restrictive parameters, we identified apolipoprotein A1 (ApoA1) and α-1 antitrypsin as differentially expressed between the two diagnostic groups. A validation experiment, with the determination of both proteins in 25 forensic cases (16 drowned and 9 controls) was performed, and we corroborated ApoA1 higher value...

Journal of Public Health Research, 2018

The healthcare professional plays a key role in the detection and subsequent channeling of a situ... more The healthcare professional plays a key role in the detection and subsequent channeling of a situation of violence to a judicial level for appropriate investigation. The mandatory reporting of gender violence has become a controversial issue among health care practitioners and victims. The objective of this study was to analyze the quality of the way in which injury reports on victims of gender violence is completed, through an analysis of the information they include, the readability and the degree to which the document can be understood. A retrospective study in a sample of 197 injury reports were performed from health services (primary care, hospital services and emergency services). We analyzed 22 variables related to the content, readability of the document, the victim's identification data as well as identification of the doctor responsible for assistance, the moment of assistance and the characteristics of the injury. The most frequent deficiencies in the data are identif...

Journal of Public Health Research, 2018

The information process is considered a core element in decision- making and an obligatory matter... more The information process is considered a core element in decision- making and an obligatory matter of concern for the health professional. Rather than information per se, we should perhaps mention the need for communication between the health professional and the patient, which should be appropriate to each specific case and situation. Interaction and communication during the relationship generates a degree of trust that contributes to improving care quality and health-related results. The aim of this study is to know the perception of professionals on the quality of communication and its impact on the decision-making process of the patient and the degree of involvement of health professionals in the process of communication with the patient. A sample of 2186 health professionals (1578 nurses, 586 physicians, and 22 pharmacists) was studied. A questionnaire composed of 20 items dealing with the process of communication with the patient and obtaining informed consent was administered....

Archives of Medical Science, 2018

IntroductionThe Child-Pugh and model for end-stage liver disease (MELD) scores are widely used to... more IntroductionThe Child-Pugh and model for end-stage liver disease (MELD) scores are widely used to predict the outcomes of liver transplant (LT). Both have similar prognostic values in most cases, although their benefits might differ in some specific conditions. The aim of our study was to analyze the influence of pre-transplant ascites and encephalopathy in post-transplant liver rejection development and survival in alcohol cirrhosis (AC) patients undergoing LT to determine the usefulness of the Child-Pugh score for the assessment of prognosis in such patients.Material and methodsTwo hundred and eighty-one AC patients, classified according to viral infections and pre-transplant complications, were analyzed. Acute (AR) and chronic (CR) liver rejections and Child-Pugh, MELD and albumin-bilirubin (ALBI) scores were studied in all cases.ResultsSimilar AC rejection percentages were observed in ascites or encephalopathy groups (18.5% and 16.5%, p = 0.735), although a higher but not statis...

Journal of Forensic Sciences, 1989