Tifus murino en España durante el periodo 2004-2013

[ES] Objetivos: Estimar la incidencia y otros datos epidemiológicos del tifus murino en España. Material y métodos: Se analizaron aquellos pacientes cuyo diagnóstico al alta hospitalaria entre los años 2004-2013 se hubiera codificado en el CMBD, según el CIE 9-MC, como 081.0 (tifus endémico murino portado por pulgas). Resultados: Se diagnosticaron 56 pacientes (83,93% como diagnóstico principal y 16,07% como secundario) y 50 de ellos se detectaron en las Islas Canarias. La tasa de incidencia global por millón de habitantes y año, fue de 0,13 (IC95% de 0,10 a 0,17) en España. La media de edad fue de 49,75 años y un rango de 8-84 años. El riesgo relativo (RR) hombre-mujer fue 1,7:1. La mayoría de casos se concentraron en el tercer trimestre del año. Conclusiones: La incidencia del TM en España es baja y heterogénea. La enfermedad se detectó principalmente en Canarias, varones y el tercer trimestre del año. [EN] Objectives: To estimate the incidence and other epidemiological data of murine typhus in Spain. Material and methods: We analyzed those patients whose diagnosis at hospital discharge between 2004-2013 years had been coded in the Hospitalization Minimum Data Set, according to the ICD 9-MC, as 081.0 (Typhus, Endemic Flea-Borne). Main results: 56 patients were diagnosed (83.93% as main diagnosis and 16.07% as secondary) and 50 of them were detected in the Canary Islands. The global incidence rate per million inhabitants per year was 0.13 (CI95% from 0.10 to 0.17) in Spain. The mean age was 49.75 years and a range of 8-84 years. The relative risk (RR) male-female was 1.7: 1. The majority of cases were concentrated in the third quarter of the year. Conclusions: The incidence of TM in Spain is low and heterogeneous. The disease was detected mainly in the Canary Islands, males and the third quarter of the year

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Anales de Edafología y Agrobiología Tomo 47 Número 3-4

Suelos. Física. Resistencia del suelo y susceptibilidad a la compactación en terrenos a monte sometidos a pastoreo. Por R. Pérez Moreira y F. Diaz-Fierros Viqueira.-- La reserva de agua útil de los suelos de Galicia. l. Relación con la textura y el contenido de materia orgánica. Por A. M. Martinez Cortizas.-- Química Empleo de aminas alifáticas en el estudio de asociaciones haloisita-esmectita en suelos. Por F. J. Aragoneses, J. Casas, y J. L. Martin de Vidales.-- Quelación por EDDHA de micronutrientes en suelos calizos. Ecuación de límite máximo. Por M. Juárez, J. Sánchez-Andréu, L. Pla y J. Jorda.-- Quelación por EDDHA de micronutrientes en suelos calizos. Ecuación de orden "n ".Por J. Sánchez-Andréu, M. Juarez, L. Pla y J. Jordá.-- Génesis, Clasificación y Cartografía Caracterización de un podsol ferro - húmico en el Puerto de la Quesera (Sierra del Ayllón). Por R. Espejo Serrano, F. Guerrero López y A. Saa Requejo.-- Natrixerales en el Baix Segre (Lleida). Por J. Bech i Borrás, J. Garrigo i Reixach y J. R. Torrento i Marselles.-- Aspectos micromorfológicos del horizonte superior en suelos artificiales (Sorribas) de las Islas Canarias. Por A. Rodríguez Rodríguez y J. M. Ontañón Sánchez.-- Fertilidad Influencia de diferentes factores del suelo sobre su contenido en microelementos asimilables: Mn, Fe, Cu y Zn. Por B. C. Ortega, Ma C. Ortega y J. G. de las Heras.--Incidencia de la salinidad del agua de riego en la mineralización del nitrógeno orgánico en suelos calizos del sureste español. Por J. García-Serna, J. Sánchez Andréu, M. Juárez y J. Mataix.-- Biología Vegetal-Fisiología Efectos de la toxicidad del flúor sobre el ciclo biológico en especies herbáceas dicotiledoneas. Por M. Ibarra, F. López Belmonte y Ma A. Diez.-- Efectos de la toxicidad del flúor sobre el ciclo biológico de especies de monocotiledoneas. Por M. Ibarra, F. López-Belmonte y Mª A . Diez.-- Proteasas ácidas en uvas Vitis vinifera (variedad Macabeo). l. Actividad proteásica durante su maduración. Por J. Marín Expósito, C. Miguel Gordillo, J. l. Maynar Mariño y J. L. Mesias Iglesias.-- Agro biología Efectos de enmiendas calcáreas en suelos fijadores de fósforo. Por S. G. Ramos Hernández y N. Aguilera Herrera.-- III. Trabajo Recapitulativo. Una deriva hacia hemiparasftismo de los líquenes epifitos: Análisis fisiológico de las relaciones con sus fitoforos. Por C. VicentePeer reviewed2019-08.- CopyBook.- Libnova.- Biblioteca IC

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

La integración de la dimensión afectiva-emocional en el aprendizaje de las matemáticas

Con frecuencia, las necesidades de aprendizaje de determinados alumnos no se satisfacen durante el proceso educativo, dando lugar a la aparición de dificultades de aprendizaje en las matemáticas y en la resolución de problemas. Asimismo estas dificultades van a interferir en el rendimiento, en el aprendizaje y en su propio desarrollo personal. La formación en la escuela se ha centrado en el desarrollo cognitivo del alumnado, dejando de lado las dimensiones afectiva, social y emocional, necesarias para aprender a convivir y aprender a ser persona, desatendiendo por tanto, el desarrollo integral del alumno. En esta comunicación vamos a revisar la evolución del estudio de las emociones en las teorías de la enseñanza y del aprendizaje de las matemáticas, desde la antigua Grecia, pasando por los modelos conductuales-cognitivos-constructivistas hasta los más actuales modelos integradores.Often the needs of learning of certain pupils do not satisfy during the educational process, giving place to the appearance of difficulties of learning in the mathematics and in the resolution of problems. Likewise these difficulties are going to interfere in the performance (yield), in the learning and in his/her own personal development. The formation (training) in the school has centred on the cognitive development of the student body, leaving of side the affective, social and emotional dimensions, necessary dimensions to learn to coexist and learn to be a person, neglecting therefore, the integral development of the pupil. In this communication we are going to check the evolution of the study of the emotions in the theories of the education and of the learning of the mathematics, from the former Greece, happening (passing) for the behavioral-cognitive-constructivistas models up to the most current integration models.notPeerReviewe

Hipertensión pulmonar tromboembólica crónica asociada a fibrosis endomiocárdica del ventrículo derecho

La hipertensión pulmonar tromboembólica crónica es una secuela infrecuente de la embolia pulmonar aguda no tratada o recurrente. Los mecanismos subyacentes para el fallo de resolución del trombo son todavía inciertos. La mayoría de los pacientes se diagnostican en un estadio tardío de la enfermedad, por lo que su historia natural no es completamente conocida. Presentamos el caso de una paciente de 51 años diagnosticada e intervenida de fibrosis endomiocárdica del ventrículo derecho que, tras varios años de evolución, desarrolló hipertensión pulmonar tromboembólica crónica