Braquiterapia en el cáncer de mama.

La radioterapia es un tratamiento fundamental del cáncer de mama. Frente a la técnica clásica de Irradiación Completa de la Mama, que se mantiene como opción estándar aceptada, ha surgido un interés creciente por la irradiación parcial de la mama (APBI -Accelerated Partial Breast Irradiation-) mediante diferentes técnicas. Los últimos estudios subrayan la no inferioridad de la APBI mediante braquiterapia multicatéter instersticial frente a la radioterapia externa con boost en el lecho tumoral, siempre y cuando se lleve a cabo una adecuada selección de las pacientes candidatas. La APBI se convierte así en una alternativa razonable a la técnica estándar en mujeres que cumplan los siguientes criterios de inclusión: ≥50 años, con tumores ≤3cm, márgenes quirúrgicos negativos y sin invasión linfovascular. Entre las principales ventajas de esta técnica destacan la reducción de la toxicidad, la mejora del resultado cosmético y la satisfacción de las pacientes. No obstante, se requieren más estudios acerca de la toxicidad y diferentes modalidades de APBI, así como un seguimiento a largo plazo de estas pacientes para que los resultados sean comparables con los de seguimientos prolongados de mujeres tratadas con Irradiación Completa.Grado en Medicin

Analysis of the linguistic expression I think in a corpus of late Modern English scientific texts

The present paper deals with the relationship between modality and evidentiality, focussed specifically on the use of the expression I think in combination with other modal devices, as well as the possible pragmatic effects observed in text samples obtained from the Coruña Corpus of English Scientific Writingand whether the variable of discipline might have some effect on the functions the expression represents in these texts.Even if much research is still to be done in academic texts from a diachronic perspective, there are some previous studies on stance devices carried out within the arena of historical pragmatics (cf. Gray, Biber and Hiltunen 2011; Moskowich and Crespo 2014; Alonso-Almeida 2015). Following this tradition, we focus on the expression I think, following the work of van der Auwera and Plungian (1998) for the description of modality and modal types.El presente trabajo trata sobre la relación entre modalidad y evidencialidad. Está centrado específicamente en el uso de la expresión I thinken combinación con otros elementos modales, así como los posibles efectos pragmáticos observados en muestras de textos obtenidas del Coruña Corpus of English Scientific Writing. Asimismo, analizamos si la variable de disciplina podría tener algún efecto sobre las funciones que la expresión lleva a cabo en estos textos. Aunque todavía queda mucho por investigar en textos académicos desde una perspectiva diacrónica, hay algunos estudios previos sobre elementos de posicionamiento realizados en el ámbito de la pragmática histórica (cf. Gray, Biber y Hiltunen 2011; Moskowich and Crespo 2014;Alonso-Almeida 2015). Siguiendo esta tradición, nos centramos en la expresión I think, siguiendo el trabajo de van der Auwera y Plungian (1998) para la descripción de la modalidad y los tipos modales

Servicio de Teleasistencia: retos, cambios y progreso de la atención de las personas mayores en su domicilio

El objeto de este trabajo será la Teleasistencia reconocida por Ley como una prestación esencial de obligada provisión a colectivos como el de las personas mayores. La Teleasistencia es un apoyo básico en la vida de las personas mayores puesto que les permite permanecer en su domicilio habitual, mejorar su calidad de vida, sentirse personas autónomas e integrarse en su medio habitual. El objetivo es hacer un análisis crítico y bibliográfico del Servicio de Teleasistencia. Por ello, este trabajo consta de dos apartados bien diferenciados: por una parte, un estudio característico del colectivo de personas mayores y, por otro lado, un estudio de campo donde se analiza la evolución de la Teleasistencia en los años 2005 y 2012. En el marco de este trabajo empírico se incluyen las entrevistas realizadas a los/as principales responsables y a varias personas usuarias del Servicio de Teleasistencia de Cruz Roja, primera Institución en España en prestarlo el diseño, gestión y evaluación de este servicio.Grado en Trabajo Socia

Thermodynamics of binary mixtures 1-ethoxy-1,1,2,2,3,3,4,4,4-nonafluorobutane (HFE-7200) + 2-propanol: High pressure density, speed of sound and derivative properties

Awareness about environmental impact of greenhouse gas emissions has lead to search for other alternatives which can cover the same utility range of wellknown CFCs, HCFCs and PFCs but without their undesirable effects on the planet. Since Hydrofluoroether fluids (HFEs) have emerged as a good alternative, it is necessary to characterize their thermophysical properties in order to bring reliable data to the industry. Density and speed of sound are two of the most important physical properties because of the amount of information that they provide in the design of the machinery involved in the utilization of these fluids as well as data for the parametrization of equations of state. This paper reports a set of new data concerning high pressure density, ρ, for the binary mixture x HFE-7200 + (1 − x) 2-propanol in a broad range of pressures (0.1–140 MPa), and at several temperatures (from 293.15 to 393.15 K). Density values were correlated by employing a Tait-like equation in the same p, T ranges, and the derivative properties, that is, the isothermal compressibility κT, and the isobaric expansion αP, were determined. Excess molar volumes VE, which bring information about the change in volume observed in the mixture were also calculated for the eight mole fractions investigated. Speeds of sound, c, at 0.1 MPa were measured experimentally in the temperature range (293.15–333.15 K). By using the Laplace equation, isentropic compressibilities, κS, were calculated from density and sound velocity values

Mastectomía profiláctica contralateral en el cáncer de mama unilateral

Se ha observado una tendencia en los últimos años a un incremento de la mastectomía profiláctica contralateral en pacientes con diagnóstico de cáncer de mama unilateral, argumentada como cirugía reductora de riesgo y de prevención del desarrollo futuro de cáncer de mama en la mama sana. En contra de lo que sería esperable, el incremento de la realización de MPC no resulta mayormente explicable por un aumento de la identificación de factores de riesgo. Este hallazgo sugiere que hoy en día la MPC no se realiza exclusivamente en pacientes de alto riesgo, y puede incluso que se esté realizando en pacientes con un riesgo acumulado muy bajo de cáncer de mama contralateral. Aunque pueden considerarse otras opciones, la indicación de MPC es poco discutida para las mujeres que tienen mayor riesgo de cáncer de mama contralateral. Las motivaciones de las pacientes con bajo riesgo de desarrollar cáncer de mama contralateral son: una reducción de riesgo de cáncer de mama contralateral, una mayor supervivencia o la tranquilidad de no tener que volverse a enfrentar en el futuro con un nuevo diagnóstico y tratamiento de cáncer de mama y su preocupación por el resultado estético. Las mejoras en la mastectomía, las técnicas de reconstrucción y el acceso a ella han contribuido también al aumento de las tasas de MPC. En el momento de considerar la MPC, es importante sopesar el riesgo de CMC vs beneficio de la MPC, las comorbilidades de la paciente y el riesgo de muerte por un nuevo cáncer vs tumor primario. Y es que hay que tener en cuenta que la MPC no está libre de riesgos y las complicaciones pueden requerir procedimientos quirúrgicos adicionales con la consiguiente pérdida de la reconstrucción. Por lo tanto, el proceso de toma de decisiones debe incluir una evaluación del riesgo de la paciente de CMC, las opciones reconstructivas disponibles o la capacidad para lograr la simetría si se realiza un procedimiento unilateral, donde la paciente tenga un papel activo en la toma de decisiones, ya que esto se relaciona con mayor satisfacción de la paciente con el resultado final

Augmented Reality as a Resource for Improving Learning in the Physical Education Classroom

We acknowledge the researchers of the research group AreA (HUM-672), which belongs to the Ministry of Education and Science of the Junta de Andalucía and is registered in the Department of Didactics and School Organization of the Faculty of Education Sciences of the University of Granada.Recently, there has been a proliferation of technopedagogical practices, based on the application of active teaching and learning processes through the use of information and communication technologies (ICT). The main objective of this work is to analyse the impact of training action through the use of augmented reality in physical education for the development and acquisition of spatial orientation, as opposed to more traditional training based on the exhibition method. The methodology developed is quantitative, through a quasi-experimental design post-test in 140 high school students in the field of physical education. The results indicate that all of the dimensions show a very high, significant relationship. The greatest difference in average is observed in motivation. In contrast, the smallest difference, although significant, is observed in the grades given by the teachers themselves. It can be concluded that the method of teaching through augmented reality is effective in teaching high school students in the subject of physical education, especially for the acquisition of spatially oriented content.Corporacion Escuela Tecnologica del Oriente ISPRS-2017-7202Secretariat of Education of Santander ISPRS-2017-7202AreA HUM/672 Research Group of the University of Granada ISPRS-2017-720

Efecto de la crisis económica sobre el consumo de psicofármacos en Asturias

ResumenObjetivoEvaluar si la crisis económica de 2008ha comportado cambios en la evolución del consumo de ansiolíticos, hipnótico-sedantes y antidepresivos en Asturias.MétodoEstudio descriptivo y de utilización de medicamentos durante 2003-2013. Se calcularon las dosis diarias definidas por 1000 habitantes/día (DHD) de ansiolíticos, hipnótico-sedantes y antidepresivos. Se obtuvieron coeficientes de regresión lineal (b) de las DHD de la etapa precrisis (2003-2008) y de la etapa de crisis (2009-2013).ResultadosEl consumo de ansiolíticos creció un 40,25%, el de hipnóticos un 88,11% y el de antidepresivos un 80,93%. Para los ansiolíticos: b-(2003-2008)=4,38 DHD/año y b-(2009-2013)=1,08 DHD/año. Para los hipnótico-sedantes: b-(2003-2008)=2,30 DHD/año y b-(2009-2013)=0,40 DHD/año. Para los antidepresivos: b-(2003-2008)=5,79 DHD/año y b-(2009-2013)=2,83 DHD/año.ConclusionesEl incremento del consumo para los tres subgrupos en la época de crisis fue menor que en la época precrisis. No se confirma que la crisis económica haya influido aumentando el consumo de estos medicamentos.AbstractObjectiveTo assess whether the economic crisis of 2008 has changed the consumption of anxiolytics, hypnotics-sedatives and antidepressants in Asturias (Spain).MethodWe conducted a descriptive study of drug use from 2003 -2013. The defined daily doses of 1000 inhabitants per day (DHD) were calculated for anxiolytics, hypnotics-sedatives and antidepressants. Linear regression coefficients (b) of the DHD were obtained for the pre-crisis period (2003-2008) and the crisis period (2009-2013).ResultsThe consumption of anxiolytics increased by 40.25%, that of hypnotics by 88.11% and that of antidepressants by 80.93%. For anxiolytics: b-(2003-2008)=4.38 DDI/year and b-(2009-2013)=1.08 DDI/year. For hypnotics-sedatives: b-(2003-2008)=2.30 DDI/year and b-(2009-2013)=0.40 DDI/year. For antidepressants: b-(2003-2008)=5.79 DDI/year and b-(2009-2013)=2.83 DDI/year.ConclusionsThe rise in consumption of the three subgroups during the crisis period was lower than that of the pre-crisis period. This study does not confirm the influence of the economic crisis on the rise in consumption of these drugs

Effectiveness of a multifactorial intervention in increasing adherence to the mediterranean diet among patients with diabetes mellitus type 2: a controlled and randomized study (EMID Study)

The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns and has benefits such as improving glycaemic control among patients with type 2 diabetes (T2DM). Our aim is to assess the effectiveness of a multifactorial intervention to improve adherence to theMD, diet quality and biomedical parameters. The EMID study is a randomized and controlled clinical trial with two parallel groups and a 12-month follow-up period. The study included 204 subjects between 25–70 years with T2DM. The participants were randomized into intervention group (IG) and control group (CG). Both groups received brief advice about healthy eating and physical activity. The IG participants additionally took part in a food workshop, five walks and received a smartphone application for three months. The population studied had a mean age of 60.6 years. At the 3-month follow-up visit, there were improvements in adherence to the MD and diet quality of 2.2 and 2.5 points, compared to the baseline visit, respectively, in favour of the IG. This tendency of the improvement was maintained, in favour of the IG, at the 12-month follow-up visit. In conclusion, the multifactorial intervention performed could improve adherence to the MD and diet quality among patients with T2DM.Regional Health Management through the 2016 grants to carry out research projects in biomedicine, health management and socio-health care (GRS 1276/B/16), the 2016 program for the professional development of nurses in their research activity (BOCYL-D-11022016-2) and the 2015 incentive program for nurses who have completed their residency (ORDER SAN / 360/2015). The study was also co-financed by the Carlos III Health Institute and the European Regional Development Fund (ERDF) (RD 16/0007/0003)

Assessment of different spent mushroom substrates to bioremediate soils contaminated with petroleum hydrocarbons

Bioremediation techniques are being developed as substitutes for physical–chemical methodologies that are expensive and not sustainable. For example, using the agricultural waste spent mushroom substrate (SMS) which contains valuable microbiota for soil bioremediation. In this work, SMSs of four cultivated fungal species, Pleurotus eryngii, Lentinula edodes, Pleurotus ostreatus, and Agaricus bisporus were evaluated for the bioremediation of soils contaminated by petroleum hydrocarbons (TPHs). The bioremediation test was carried out by mixing the four different SMSs with the TPH-contaminated soil in comparison with an unamended soil control to assess its natural attenuation. To determine the most efficient bioremediation strategy, hydrolase, dehydrogenase, and ligninolytic activities, ergosterol content, and percentage of TPHs degradation (total and by chains) were determined at the end of the assay at 40 days. The application of SMS significantly improved the degradation of TPHs with respect to the control. The most effective spent mushroom substrate to degrade TPHs was A. bisporus, followed by L. edodes and P. ostreatus. Similar results were obtained for the removal of aliphatic and aromatic hydrocarbons. The results showed the effectiveness of SMS to remove aliphatic and aromatic hydrocarbons from C10 to C35. This work demonstrates an alternative to valorizing an abundant agricultural waste as SMS to bioremediate contaminated soil

Reproducibility Study of Nocturnal Blood Pressure Dipping in Patients with High Cardiovascular Risk

It has been shown that in most people there is a physiological reduction in blood pressure during nighttime sleep, it falling by approximately 10% compared to daytime values (dippers). On the other hand, in some people, there is no nighttime reduction (non-dippers). Various studies have found an association between being a non-dipper and a higher risk of cardiovascular disease, but few have assessed whether the nocturnal pattern is maintained over time. From the database of the TAHPS study, data were available on 225 patients, each of whom underwent 24-hour ambulatory blood pressure monitoring (ABPM) on four occasions over a period of 5 months. We studied the reproducibility of the nocturnal BP dipping pattern with mixed linear analysis and also calculated the concordance in the classification of patients as dippers or non-dippers. The intraclass correlation coefficients between the different ABPM recordings were 0.482 and 0.467 for systolic and diastolic blood pressure, respectively. Two-thirds (67%) and 70% of the patients classified, respectively, as dippers or non-dippers based on systolic and diastolic blood pressure readings in the first ABPM recording were found to have the same classification based on the subsequent recordings. We conclude that the reproducibility of nocturnal dipping patterns and concordance of dipper vs non-dipper status in individual patients is modest and therefore that we should be cautious about recommending treatments or interventions based on these patterns.A grant was received from the Department of Pharmacy of the Spanish Health Ministr