Marta Elena Losa Iglesias

King Juan Carlos University, Madrid, Spain

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Publications (58)65.25 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Functional hallux limitus (FHL) has been implicated in the development of metatarsophalangeal joint osteoarthritis.
    Prosthetics and orthotics international. 09/2014;
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    ABSTRACT: For treatment of ingrown toenails, a phenolization approach is often chosen. Many reports describe a lavage of the wound with alcohol to neutralize any residual phenol; however, it remains uncertain if there is a more effective solution for use in the lavage step. The aim of our study was to analyze the suitability and effectiveness of 0.1% polihexanide solution compared with isopropyl alcohol in the removal of excess phenol after treatment for ingrown toenails. We performed an in vitro study using human matrix and a diffusion cell apparatus to measure the amount of phenol remaining after two lavage washes. The effect of phenol evaporation was also examined.When phenol was irrigated with alcohol alone, 27.43 ± 4.10 mg (57.74%) of the initial amount of phenol was recovered. If irrigated with 0.1% polihexanide, 35.98 ± 2.93 mg (75.74%) of phenol was recovered. These results indicate that a polihexanide lavage step has significantly higher efficiency for removing excess phenol relative to alcohol.
    Dermatologic Therapy 08/2014; · 1.96 Impact Factor
  • Ref. No: P201400473, Year: 06/2014
  • Journal of the European Academy of Dermatology and Venereology 03/2014; · 2.69 Impact Factor
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    ABSTRACT: Phenolization is often used to treat ingrown toenails. Alcohol lavage with or without supplemental chlorhexidine may be used to remove residual phenol, which can contribute to side effects such as persistent oozing or drainage. We sought to compare the effectiveness in removing residual phenol of lavage with alcohol plus chlorhexidine versus alcohol alone. We studied 80 patients who underwent unilateral phenol matricectomy: 40 who received irrigation with alcohol alone and 40 who received irrigation with alcohol plus chlorhexidine. Phenol levels were measured after each of 5 rounds of 3-mL irrigations. After the first irrigation, an average of 44.92% and 38.35% of the phenol remained in the nailfold in the alcohol and the alcohol/chlorhexidine groups, respectively (P < .05). After all 5 irrigations, no difference in efficacy between the 2 solutions was found (P > .005). It was not possible to calculate the quantity of phenol initially introduced into the nail bed. The percentage remaining was calculated from the total amount of phenol recovered. When a single irrigation step is performed after phenolization, alcohol plus chlorhexidine is more effective than alcohol alone for removing residual phenol. When multiple irrigations are performed, the 2 solutions are equally effective.
    Journal of the American Academy of Dermatology 03/2014; · 4.91 Impact Factor
  • Marta Elena Losa Iglesias, Ricardo Becerro de Bengoa Vallejo
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    ABSTRACT: Background : There is a high prevalence of musculoskeletal complaints related to day-to-day work among podiatric physicians. We sought to determine the relationships among musculoskeletal pain, job satisfaction, depression, and anxiety in Spanish podiatric physicians. Methods : A convenience sample of 421 Spanish podiatric physicians was administered a survey that included questions about sociodemographic variables, musculoskeletal pain, job satisfaction, depression, and anxiety. Results : On average, respondents were found to have a high level of pain, a moderate level of job satisfaction, and low-to-moderate levels of depression and anxiety. Young single women had the highest levels of pain and anxiety. Analysis with the Student t test indicated significant differences between the sexes for levels of pain (P < .0001) and anxiety (P < .014). Job satisfaction was inversely related to depression and anxiety. Conclusions : These findings, particularly the increased levels of pain, job dissatisfaction, anxiety, and depression in young single female podiatrists, indicate a need for strategies to reduce the risks posed by the work environment in podiatric medicine, thus minimizing the negative psychological and physical consequences of participating in the profession.
    Journal of the American Podiatric Medical Association 03/2014; 104(2):191-7. · 0.77 Impact Factor
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    Marta Elena Losa Iglesias, Ricardo Becerro de Bengoa Vallejo
    Acta Bioethica 11/2013; 19(2):293-297. · 0.06 Impact Factor
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    ABSTRACT: Background: For treatment of ingrown toenails, a phenolization is often chosen. Many reports describe an intra-operative irrigation, or lavage, of the wound with alcohol to neutralize any residual phenol. There are conflicting reports in the literature as to whether a true neutralization is required or merely effective removal of excess phenol. We hypothesized that intra-operative irrigation with 70% alcohol after the application of phenol does not remove enough phenol and a quantity of phenol still remains in the wound nail fold performing its action. Objective: The aim of our study was to analyze the suitability and effectiveness of the alcohol lavage step during the treatment of ingrown toenails with a phenolization procedure. Methods: We performed an in vivo study in 29 patients who underwent unilateral phenol chemical matricectomy to measure the amount of phenol remaining after five irrigations with a total of 15 ml of alcohol. Results: There were measurable amounts of phenol collected after five alcohol irrigation steps, suggesting that phenol was not neutralized by the alcohol. After the first irrigation, only 45.74% of phenol was eliminated. An additional 12 ml of alcohol were necessary to eliminate the remaining 54.25% in the nail bed. Conclusions: A single alcohol lavage step after the phenolization procedure did not eliminate enough phenol. However, 15 ml of alcohol can serve as a suitable and effective means of diluting and removing any excess or residual phenol from the exposed area by its drag effect.
    European journal of dermatology : EJD. 06/2013;
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    Marta Elena Losa Iglesias, Ricardo Becerro de Bengoa Vallejo
    Acta Bioethica 06/2013; 19(1):113-123. · 0.06 Impact Factor
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    ABSTRACT: BACKGROUND: A phenolization approach is often chosen for treatment of ingrown toenails. Many reports describe lavage of the wound with alcohol to neutralize any residual phenol. The aim of our study was to compare the suitability and effectiveness of a solution consisting of alcohol plus chlorhexidine with that of alcohol alone in a lavage step during the treatment of ingrown toenails using a phenolization procedure. METHODS: We performed an in vitro study using human matrix and a diffusion cell apparatus to measure the amount of phenol remaining after various lavage washes. The effect of phenol evaporation was also examined. RESULTS: When phenol was irrigated with alcohol alone, total phenol recovered was 29.9 ± 4.8 mg (62.9% of the initial amount). When the phenol was irrigated with isopropyl alcohol plus 0.5% chlorhexidine, 39.8 ± 1.7 mg (83.8%) of phenol was recovered. CONCLUSION: A lavage step including alcohol and chlorhexidine is more effective than alcohol alone for removal of excess phenol. The addition of chlorhexidine also contributed to inhibition of the action of phenol. This approach provides a suitable and effective means of diluting and removing any excess or residual phenol from the exposed area.
    Dermatologic Surgery 05/2013; · 1.87 Impact Factor
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    ABSTRACT: Death can be difficult to accept, unimaginable, and unexpected. Critical care nurses are directly involved with patients and their families, and their experience can identify the best practices for end-of-life care. The purpose of this descriptive study was to identify the relative importance of helpful behaviors and obstacles that affect caring for dying patients and families in both adult and pediatric intensive care units as perceived by critical care nurses. The results show that for end-of-life care, nurses most strongly value factors that focus on the well-being of the family, and similar opinions were held by nurses from both adult and pediatric intensive care units.
    Dimensions of critical care nursing: DCCN 03/2013; 32(2):99-106.
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    ABSTRACT: BACKGROUND: There is little information regarding the detrimental effects of tourniquet ischemia, although it is a widely used technique in extremity surgery. We endeavored to study some of the physiologic changes involved in the finger during the ischemic phase and throughout the recovery phase after tourniquet release. MATERIALS AND METHODS: This was a single-center, prospective observational study involving healthy adults designed to assess the appropriate application time of a digital T-ring tourniquet without a pH or acidosis <7.0 to avoid any potential risk to local tissues. RESULTS: There was no pH difference before tourniquet application between men and women, but after tourniquet application, the women's fingers became more acidotic at 10 and 20 minutes than the mens', but after 30 minutes the acidosis of the two groups was similar. Participants who weighed less had a more acidotic pH level than heavier participants. LIMITATIONS: This study was performed in a laboratory setting on healthy people rather than on those with existing medical conditions, so clinical recommendations cannot be explicitly made. CONCLUSION: Tourniquet application time is precious. While operating under tourniquet control, the extremity becomes increasingly acidotic. Tourniquet ischemia longer than 20 minutes causes local acidosis and muscle fatigue. Women and persons who weighed less could reach acidotic pH values faster than men or heavier patients. If applications longer than 20 minute are expected, the tourniquet should be released at 20 minutes, allowing the finger to reperfuse for 3-5 minutes to clear the acidosis before reapplication of tourniquet.
    Dermatologic Surgery 01/2013; · 1.87 Impact Factor
  • Marta Elena Losa Iglesias, Ricardo Becerro de Bengoa Vallejo
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    ABSTRACT: Abstract Background: Managers, including those in nursing environments, may spend much of their time addressing employee conflicts. If not handled properly, conflict may significantly affect employee morale, increase turnover, and even result in litigation, ultimately affecting the overall well-being of the organization. A clearer understanding of the factors that underlie conflict resolution styles could lead to the promotion of better management strategies. Objective: The aim of this research was to identify the predominant conflict resolution styles used by a sample of Spanish nurses in two work settings, academic and clinical, in order to determine differences between these environments. The effects of employment level and demographic variables were explored as well. Design: Descriptive cross-sectional survey study. Participants: Our sample consisted of professional nurses in Madrid, Spain, who worked in either a university setting or a clinical care setting. Within each of these environments, nurses worked at one of three levels: full professor, assistant professor, or scholarship professor in the academic setting; and nursing supervisor, registered staff nurse, or nursing assistant in the clinical setting. Methods: Conflict resolution style was examined using the standardized Thomas-Kilmann Conflict Mode Instrument, a dual-choice questionnaire that assesses a respondent's predominant style of conflict resolution. Five styles are defined: accommodating, avoiding, collaborating, competing, and compromising. Participants were asked to give answers that characterized their dominant response in a conflict situation involving either a superior or a subordinate. Descriptive and inferential statistics were used to examine the relationship between workplace setting and conflict resolution style. Results: The most common style used by nurses overall to resolve workplace conflict was compromising, followed by competing, avoiding, accommodating, and collaborating. There was a significant overall difference in styles between nurses who worked in an academic vs. a clinical setting (p = 0.005), with the greatest difference seen for the accommodating style. Of those nurses for whom accommodation was the primary style, 83% worked in a clinical setting compared to just 17% in an academic setting. Conclusion: Further examination of the difference in conflict-solving approaches between academic and clinical nursing environments might shed light on etiologic factors, which in turn might enable nursing management to institute conflict management interventions that are tailored to specific work environments and adapted to different employment levels. This research increases our understanding of preferred approaches to handling conflict in nursing organizations.
    Contemporary nurse: a journal for the Australian nursing profession 12/2012; 43(1):73-80. · 0.44 Impact Factor
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    Journal of the European Academy of Dermatology and Venereology 08/2012; · 2.69 Impact Factor
  • Marta Elena Losa Iglesias, Ricardo Becerro de Bengoa Vallejo
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    ABSTRACT: Abstract Background: Bullying has been recognized as an important and increasing problem for nurses, who are faced with different kinds of bullying. Recent research has suggested a possible association between bullying and low self-esteem. Objective: To determine the prevalence of bullying at work in a sample of Spanish nurses; to examine the association between bullying and self-esteem; and to investigate the prognostic factors that determine bullying at work. Design: A descriptive survey study was developed to represent the population of Spanish nurses. Participants: The sample consisted of 538 nurses who met the inclusion criteria of having worked for a minimum of one year in adult or paediatric services in the public or private heath care system of Principado de Asturias-Spain. Methods: The Rosenberg Self-Esteem Scale (RSE) and the Negative Acts Questionnaire (NAQ) standardized for Spain were used to measure self-esteem and bullying behaviours respectively. Results: Our results show that about one in five nurses (17%) experienced subjective bullying, and 8% of these cases reported weekly or daily bullying. The negative acts reported most frequently in bullied and non-bullied nurses were work-related bullying behaviours, such as 'Being given tasks with unreasonable or impossible targets or deadlines' (2.71 SD = 1.33). However, bullied nurses reported significantly higher rates in all questions of the NAQ, and self-reported bullying was significantly related to low self-esteem (χ(2) = 109; p < 0.001). Conclusion: Prevalence of self-reported bullying is high among Spanish nurses and is clearly associated with higher exposure to bullying behaviours at work and lower levels of self-esteem.
    Contemporary nurse: a journal for the Australian nursing profession 08/2012; 42(1):2-10. · 0.44 Impact Factor
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    ABSTRACT: Phenol cauterization is a chemical equivalent often chosen for treatment of ingrown toenails. Many reports describe intraoperative irrigation, or lavage, of the wound with various types of alcohol to neutralize any remaining phenol. There are conflicting reports in the literature as to whether true neutralization or merely effective removal of excess phenol is needed. The aim of our study was to analyze the suitability and effectiveness of ethyl alcohol versus sterile saline when used in a lavage step after phenol application in the treatment of ingrown toenails. We performed an in vitro study using human skin and a diffusion cell apparatus to measure the amount of phenol recovered after lavage with ethyl alcohol or sterile saline. When the wound was irrigated with ethyl alcohol, the total phenol recovered after two irrigation washes was 55.7% of the original amount initially used in treatment, compared with 80.4% when sterile saline solution was used for irrigation. Alcohol and sterile saline solution do not neutralize phenol but dilute it and aid in its removal. We found that saline solution recovered more phenol than when washing with alcohol and recommend its use instead of alcohol for irrigation purposes after chemical matrixectomy.
    Dermatologic Surgery 08/2012; 38(8):1296-301. · 1.87 Impact Factor
  • Ricardo Becerro de Bengoa Vallejo, Marta Elena Losa Iglesias, Kevin T Jules
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    ABSTRACT: Hallux valgus, limitus, and rigidus are conditions affecting the first metatarsophalangeal joint that can be treated by arthroplasty. Excessive arthroplasty can compromise the insertion of the tendons at the base of the proximal phalanx of the hallux, leading to first metatarsophalangeal joint plantarflexion weakness, cock-up toe deformity, and altered forefoot loading. The present study investigated the anatomic length of insertion of the medial and lateral flexor hallucis brevis, extensor hallucis brevis, abductor hallucis, and adductor hallucis tendons into the base of the hallux proximal phalanx and the amount of bone that can be safely resected without compromising the insertional limits. A total of 43 specimens (22 right and 21 left) from 22 embalmed cadavers (11 male and 11 female) were dissected. The insertion lengths of the 5 tendons were measured, along with the dimensions of the hallux proximal phalanx. No statistically significant differences were found in any proximal phalanx measurements or tendon insertion lengths according to side (p > .05). Significant differences were found between the genders in most dimensions of the hallux proximal phalanx (p < .05). The medial insertion site, where the medial flexor brevis tendon and distal abductor hallucis muscle join, was longer than the lateral site (p < .001). To preserve the tendon's insertion, hallux proximal phalanx resection should not exceed 3 mm. Resection of the tendons is ensured by removal of more than 7.88 mm and 9.37 mm in females and males, respectively. When performing hallux arthroplasty of the first metatarsophalangeal joint, we recommend calculating the length of the tendon insertions, instead of the length of the hallux proximal phalanx.
    The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons 07/2012; 51(6):729-33.
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    ABSTRACT: Phenol has been used for more than 60 years in the treatment of ingrown toenails. Many reports have documented the safety and effectiveness of phenol matricectomy, although with variable treatment application times. We performed research to determine the application time required for phenol matricectomy for complete denaturation of the nail matrix to occur at a concentration of 88%. Identifying the optimal time required to destroy the germinal matrix without causing further soft-tissue damage should reduce the potential for complications. Thirty anatomic cadaveric fresh hallux samples were used to perform phenol matricectomy. The applications were for 1 to 6 minutes using 10 samples per time point and analyzed by hematoxylin-eosin staining to determine the presence or absence of the basal or germinal layer of the nail bed epithelium (NBE). After a 1-minute application of 88% phenol solution, only superficial damage to the NBE was noted, with the basal layer primarily intact. After a 2-minute application, the nail plate was avulsed with a thin basal layer remaining. After a 3-minute application, full-thickness necrosis of the NBE was noted in 6 of the 10 specimens. After 4-, 5-, and 6-minute applications, full-thickness necrosis of the NBE was noted and the basal layer was completely destroyed in all 30 specimens. The study was performed in cadaveric fresh specimens. Application of 88% phenol solution for at least 4 minutes is necessary for complete destruction of the nail matrix, creating an environment that avoids nail regrowth.
    Journal of the American Academy of Dermatology 05/2012; 67(4):706-11. · 4.91 Impact Factor
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    ABSTRACT: A significant predictor of falls in the elderly population is attributed to postural instability. Thus, it is important to identify and implement practical clinical interventions to enhance postural stability in older adults. Shoe insoles have been identified as a mechanism to enhance postural control, and our study aimed to evaluate the impact of 2 shoe insoles on static standing balance in healthy, older adults compared with standing posture while barefoot. We hypothesized that both hard and soft shoe insoles would decrease postural sway compared with the barefoot condition. Indeed, excursion distances and sway areas were reduced, and sway velocity was decreased when wearing insoles. The hard insole was also effective when visual feedback was removed, suggesting that the more rigid an insole, the greater potential reduction in fall risk. Thus, shoe insoles may be a cost-effective, clinical intervention that is easy to implement to reduce the risk of falling in the elderly population.
    Geriatric nursing (New York, N.Y.) 03/2012; 33(4):264-71. · 0.79 Impact Factor
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    ABSTRACT: Moral distress is a stress symptom arising from situations that involve ethical dimensions where the health-care provider believes that he or she is unable to preserve all interests and values at stake. The aims of this study were to evaluate the impact of, and identify possible differences in, moral distress in podiatric physicians in the United States and Spain and to determine the ethical principles most closely related to moral distress. A 2008 e-mail survey of 93 US podiatric physicians and 93 Spanish podiatric physicians (N = 186) presented statements about different ethical dilemmas, values, and goals in the workplace. Although moral distress is strongly present across the sample for all of the questions, the US sample shows higher levels of any kind of moral distress concerning questions about patients' treatment and economic constraints, overload of paperwork, and acting against one's conscience. In the US sample, 91.4% of physicians agreed mostly or completely with the statement that they often had to compromise their own values to cope with the demands of the workplace; 89.25% of US podiatric physicians indicated that their own professional values were congruent with the values of the organization; and a similar percentage (77.5%) reported a strong identification with the goals and framework of their work organization. The Spanish sample had similar results. The results underline the significance of moral distress for both samples, mainly related to time constraints and organizational aspects concerning patients and lack of resources.
    Journal of the American Podiatric Medical Association 01/2012; 102(1):57-63. · 0.77 Impact Factor

Publication Stats

56 Citations
65.25 Total Impact Points

Institutions

  • 2008–2014
    • King Juan Carlos University
      • • Facultad de Ciencias de la Salud
      • • Departamento de Enfermería, Ginecología y Obstetricia, Pediatría y Psiquiatría
      Madrid, Spain
  • 2008–2011
    • Complutense University of Madrid
      • • Facultad de Medicina
      • • Departamento de Microbiología III
      Madrid, Madrid, Spain
  • 2003
    • European University of Madrid
      Madrid, Madrid, Spain