Novedades en la endocarditis infecciosa

Infective endocarditis is a continually evolving disease. Present-day patients differ significantly from those treated a few decades ago: they tend to be older and have more comorbidities and health care-related episodes, while new groups of patients have emerged with new types of endocarditis, such as those affecting patients with percutaneous valve prostheses. There have also been changes in diagnostic techniques. Although transthoracic and transesophageal echocardiography are still the most commonly used imaging modalities, other techniques, such as 3-dimensional transesophageal ultrasound, cardiac computed tomography, and nuclear medicine tests (PET/CT and SPECT/CT), are increasingly used for diagnosing both the disease and its complications. In recent years, there have also been significant developments in antibiotic therapy. Currently, several treatment strategies are available to shorten the hospital phase of the disease in selected patients, which can reduce the complications associated with hospitalization, improve the quality of life of patients and their families, and reduce the health care costs of the disease. This review discusses the main recent epidemiological, diagnostic and therapeutic developments in infective endocarditis.La endocarditis infecciosa es una enfermedad en continuo cambio. Los pacientes atendidos en la actualidad en nada se parecen a los de hace unas décadas: son de más edad, tienen más comorbilidades y más episodios asociados con los cuidados sanitarios. Además, han surgido nuevos grupos de pacientes con formas de endocarditis que antes no existían, como las que afectan a portadores de implantes percutáneos de prótesis valvulares. Las técnicas para el diagnóstico de la enfermedad también han cambiado. Aunque las ecocardiografías transtorácicas y transesofágicas siguen siendo las pruebas de imagen más utilizadas, cada vez son más frecuentes otras técnicas, como la ecografía transesofágica tridimensional, la tomografía computarizada cardiaca y las pruebas de medicina nuclear (PET-TC y SPECT-TC) tanto en el diagnóstico de la enfermedad como en sus complicaciones. En los últimos años también ha habido novedades muy significativas respecto al tratamiento antibiótico. En la actualidad contamos con diferentes estrategias de tratamiento para acortar la fase hospitalaria de pacientes concretos y reducir las complicaciones asociadas con el ingreso, mejorar la calidad de vida de los pacientes y sus familiares y reducir el coste sanitario relacionado con la enfermedad. En esta revisión, se comentan las principales novedades epidemiológicas, diagnósticas y terapéuticas de la endocarditis infecciosa.Instituto de Salud Carlos III (PI22/00459)Gerencia Regional de Salud de Castilla y León (GRS 2657/A/22)5.9 Q1 JCR 20221.991 Q1 SJR 2023No data IDR 2022UE

Involving Persons With Lived Experience to Improve Vocational Students’ Stigmatizing Attitudes Toward Mental Disorders: A Quasi-Experimental Study

BACKGROUND: Mental health problems are estimated to affect one in six individuals in the European Union. Fifty percent of mental disorders start in adolescence, around the age of 14. The stigma associated with having a mental health problem is one of the main barriers to seeking help for psychiatric and psychological disorders among adolescents and young adults. Interventions to reduce social stigma could contribute to increased help-seeking behavior in this population. AIMS: To assess the effectiveness of a direct contact intervention in the classroom by persons with lived experience to reduce vocational students’ stigmatizing attitudes. METHOD: One person with lived experience and one first-degree relative implemented a classroom intervention lasting 90 min. Its effectiveness was measured using a quasi-experimental study with a pretest–posttest design and within-subject control. RESULTS: A total of 128 students from three different Vocational and Technical Schools from Spain participated in the study. After the intervention, statistically significant differences were observed in the scores of 11 of the 13 dimensions measured with the Spanish Mental Illness Stigma Attribution Questionnaire (AQ-27-E) and the Community Attitudes toward Mental Illness (CAMI) questionnaires. No differences associated with gender or familiarity with the mental disorder were observed. CONCLUSION: Vocational students’ negative attitudes and emotions can be improved through a direct contact intervention in the classroom involving people who have experienced a mental disorder themselves. The age range for optimal results with this type of intervention appears to be 18 to 20 years.Sin financiación2.0 Q2 JCR 20220.587 Q2 SJR 2022No data IDR 2022UE

El departamento de comunicación en las instituciones europeas y organización de la función comunicativa

INTRODUCCIÓN En ocasiones nos referimos a la Unión Europea de forma abstracta, como un todo. Detrás de ello existe un engranaje formado por diferentes organismos que, actuando de forma conjunta, generan una actividad constante que pone en marcha una política común. La Unión ha evolucionado desde sus primeras formaciones. En 1951, la firma del Tratado de París supuso la constitución de la denominada Comunidad Europea del Carbón y el Acero (CECA), formada con el objetivo de regular y ejecutar las políticas comunes en estas dos industrias y sus mercados; esta se constituía de un órgano político-ejecutivo que funcionaba como institución rectora (conocida como Alta Autoridad), una asamblea de miembros (denominada Asamblea Parlamentaria), un Consejo de Ministros y otros dos instituciones: un tribunal de justicia y un órgano de carácter consultivo. Aquí germinan las primeras instituciones de la Unión Europea actual: la Comisión Europea, el Parlamento Europeo y el Consejo Europeo, además del Tribunal Europeo de Justicia. En paralelo, en el año 1957, surgen dos nuevos tratados internacionales que buscan ampliar las vías de unidad y cooperación europea, conocidos como los Tratados de Roma, y que constituían la Comunidad Económica Europea (CEE) y la Comunidad Europea de la Energía Atómica (CEEA, también conocida como EURATOM). La Comunidad Económica Europea contaba, a su vez, con un órgano parlamentario, la Asamblea (Posterior Parlamento Europeo) La creación de la Comunidad Económica Europea y de las diferentes comunidades temáticas cultivó una necesidad de unificación de las comunidades europeas bajo un mismo sistema, que llegó en 1992, generando una Unión Europea como la conocemos hoy, que se fundamentada en el Tratado de Maastricht, y se constituía sobre la base de las comunidades europeas previas, dando origen al Tratado de la Unión Europea y que, tras diversas actualizaciones, sigue vigente en la actualidad. El marco institucional de la nueva Unión (Tratado de la Unión Europea, a partir de ahora TUE) se formó por el Consejo Europeo, el Consejo, el Parlamento Europeo, la Comisión Europea, el Tribunal de Justicia de la Unión Europea y el Tribunal de Cuentas, a las que posteriormente se incorporaría el Banco Central Europeo con la moneda única. Esta nueva estructura dio pie a la creación de comisiones de carácter consultivo (el comité económico y social, y el comité de las regiones) e instituciones subsidiarias de la nueva Unión. Este modelo de órganos independientes, pero en cohesión, es a lo que nos referimos cuando mencionamos a la Unión Europea. Este engranaje de instituciones persigue una misma finalidad, recogida en el Tratado de la Unión Europea, en el Artículo 13: “La Unión dispone de un marco institucional que tiene como finalidad promover sus valores, perseguir sus objetivos, defender sus intereses, los de sus ciudadanos y los de los Estados miembros, así como garantizar la coherencia, eficacia y continuidad de sus políticas y acciones” en la que la función comunicativa, como en cualquier institución, se vuelve esencial. Analizar, por tanto, la Unión Europea como objeto de estudio no es fácil. Menos aún cuando queremos hacerlo desde una perspectiva concreta, como la comunicación. Realizar un análisis de las estructuras de comunicación europeas conlleva una comprensión profunda de su funcionamiento y su coexistencia, y convivencia, entre sí.Sin FinanciaciónSPI 2022UE

Addressing Challenges in Wildlife Rehabilitation: Antimicrobial-Resistant Bacteria from Wounds and Fractures in Wild Birds

Wildlife rescue centers frequently admit animals with injuries and bone fractures. Open fractures are common in birds due to their anatomy, and this can lead to complications like osteomyelitis, which implies a serious bone infection and often necrosis, or death of the affected bone tissue. Antibiotic therapy is crucial, but the rise in antimicrobial-resistant isolates in wildlife raises concerns about treatment efficacy. A study focused on isolating, identifying, and assessing antimicrobial resistance in bacteria from wounds and fractures in wild birds. Among 36 isolates, Staphylococcus spp. dominated (63.8%), with 82.6% exhibiting antimicrobial resistance, particularly to clindamycin, an antimicrobial key in the treatment of infected bone fractures. This escalating resistance poses a dual threat to wildlife—therapeutic failure and the spread of resistant bacteria in ecosystems.Ministry of Ecological Transition (MITECO)Complutense University of Madrid (Spain)3.0 Q1 JCR 20220.698 Q1 SJR 2023No data IDR 202

The pulmonary rehabilitation effect on long covid-19 syndrome: A systematic review and meta-analysis

Objectives: This systematic review and meta-analysis aims to evaluate the efficacy of pulmonary rehabilitation (PR) in improving dyspnea, fatigue, physical activity, quality of life, anxiety and depression in patients with Long COVID-19 (LC). The impact of PR on LC and a comparison of face-to-face and telerehabilitation approaches was explored. Methods: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO. A literature search included PubMed, Web of Science, and Cochrane Library until January 2023. No language filters were applied. Randomized controlled trials, non-randomized controlled trials, and observational studies were included. The risk of bias was assessed using appropriate tools. Descriptive analysis and meta-analysis were performed. Forest plots presented results. Statistical analyses were conducted using the Metafor Package in R v.3.4.2. Results/Findings: This systematic review and meta-analysis included 16 studies on PR in LC patients. A total of 1027 adults were included. The studies varied in design, with seven observational studies, three quasi-experimental studies, and six randomized controlled trials. Dyspnea, physical function, quality of life, psychological state, and fatigue were assessed as outcomes. The review found that pulmonary rehabilitation had a significant positive effect on dyspnea, physical function, quality of life (both global and physical domain), anxiety, and depression. However, the effect on fatigue was not significant. Heterogeneity was observed in some analyses, and publication bias was found in certain outcomes. Age and study design were identified as potential moderators. Both face-to-face and telerehabilitation interventions improved the studied outcomes, with only differences in the physical domain of quality of life favoring the face-to-face group. Implications on Physiotherapy Practice PR improved dyspnea, physical function, quality of life, and psychological state in LC patients, but not fatigue. Face-to-face and telerehabilitation have similar effects, except for physical quality of life.Ilustre Colegio Profesional de Fisioterapeutas de la Comunidad de Madrid (España) (Premio al Mejor Proyecto de Investigación en secuelas post-COVID-19)1.7 Q2 JCR 20220.608 Q2 SJR 2023No data IDR 2022UEMUE

Inteligencia artificial e Internet of Medical Things en UCI: momento de la implementación

Sin financiación3.0 Q3 JCR 20220.364 Q2 SJR 2022No data IDR 2022UE

Economías colaborativas

Sin financiaciónSPI 2022UE

Re-exploring the relationships of humor styles with dark triad and self-esteem using structural equation modelling

Previous relationships between Dark Triad and Humor styles are theoretically difficult to interpret since Dark Triad traits present general and specific sources of variance. In the present study, we used structural equation modelling techniques to allow us to separate the two sources and detect which source of variance of Dark Triad plays the main role in the relationship observed with Humor styles. Similarly, it was tested if relationships among measures of Self-esteem and Humor styles are replicated at structural level. Moreover, the vast majority of previous studies have been conducted with university samples, which represents a limitation. Hence, a series of bi-factor models to test the relationship between Dark Triad and Humor styles and structural models for Self-esteem and Humor styles were fitted on a community sample of 987 Spanish people. Results suggest that the common variance of the Dark Triad traits was mainly responsible for the reported relationships with Humor styles. It is noteworthy that relations reported for Aggressive and Self-defeating humor styles were higher than those observed in previous studies. Similarly, a higher correlation between Self-esteem and Self-defeating was observed at the structural level. Futures studies are suggested to better establish the psychological reasons behind these relationships.Sin financiación4.3 Q1 JCR 20221.463 Q1 SJR 2022No data IDR 2022UE

Presence of Differences in the Radiofrequency Parameters Applied to Complex Pressure Ulcers: A Secondary Analysis

Abstract: Background: Pressure ulcers are a public health problem given the impact that they have on morbidity, mortality and the quality of life and participation of patients who suffer from them.Therefore, the main objective of this study was to evaluate the presence of differences in the radiofrequency parameters applied to complex pressure ulcers throughout the sessions and between the right and left leg. As a secondary objective, the subjective perceptions of the effects of the treatment by both the patients and the practitioner were analyzed. Methods: We performed a secondary analysis of data from a prospective study involving 36 patients from the Hospital de Guadarrama in Madrid, Spain, who presented ulcers in the lower limbs. Ten treatment sessions of radiofrequency were administered with a frequency of one session/week, collecting the data referring to the variables in each of the sessions. The main outcome variables were the radiofrequency parameters automatically adjusted in each session and that referred to the frequency (Hz), maximum and average power (W), absorbed energy by the ulcer (J/cm2) and temperature (◦C) reached by the tissues. On the other hand, the subjective perception of the results was evaluated using the Global Response Assessment (GRA), a Likert-type scale that scores the treatment results from 1 (significantly worse) to 5 (significantly better). Likewise, the satisfaction of both the patients and the professional were evaluated using a 10-point numerical scale. Results: The ANOVA test showed significant differences (p < 0.05) throughout the sessions except in patient satisfaction. The ANOVA test showed significant differences (p < 0.05) between both legs and over time in all parameters except for frequency. The presence of significant differences (p < 0.05) was observed over time between legs compared to the initial values in the absorbed energy and in temperature, with higher final values in the absorbed energy in the left leg compared to the right (26.31 ± 3.75 W vs. 17.36 ± 5.66 W) and a moderate effect on both (R2 = 0.471 and 0.492, respectively). The near absence of changes in the satisfaction of both the patients and the professional was observed, while the score in the GRA decreased continuously throughout the sessions. Conclusions: Radiofrequency parameters are indicative of an improved clinical response to ulcers. In addition, higher radiofrequency exposure increases healing capacity. However, the subjective perception of treatment outcomes worsened, which may be related to the chronic nature of the ulcers, leading to patients’ expectations not being met.Sin financiaciónNo data SPI 2022UE

An Observational Study in the Real Clinical Practice of the Treatment of Noninfectious Uveitis

Background: The aim of this study was to describe the characteristics of patients with uveitis associated with an immunologic or idiopathic disease that requires immunosuppressive treatment and the response to such treatments in real clinical practice. Methods: An observational, descriptive, longitudinal, and retrospective study of a cohort of patients diagnosed with noninfectious uveitis was performed. To assess the response to treatment, we evaluated the change in visual acuity, vitritis, and the presence of macular edema. Results: We included 356 patients. Overall, 12% required treatment with systemic corticosteroids, and 66 patients (18.5%) required immunosuppressive/biological treatment, with methotrexate being the most used (55%). Immunosuppressive drugs were used in 59 cases (in 56 patients, as the first choice of treatment and for 3 patients as the second choice after treatment with biologics). Treatment with biologics was the first choice in 10 patients out of 66 (15%), and 34 (48%) required them at some time during the disease, with adalimumab being the most commonly used. Thirty-five patients (53%) needed to switch drugs due to a lack of response to the first one. There were no differences between different drugs in the resolution of vitritis and improvement in vision. Conclusions: The use of systemic corticosteroids and immunosuppressive/biologics was necessary for a high number of patients with noninfectious uveitis. In our series, tocilizumab was significantly more effective in the resolution of macular edema.Sin financiación3.9 Q2 JCR 20220.882 Q1 SJR 2023No data IDR 2022UE