Pontevedra : la movilidad eco-friendly en intramuros

A finales del siglo XX, los malls peatonales fueron las soluciones prácticas a los problemas urbanos más perjudiciales, resolviendo los conflictos socio-económicos y solucionando los conflictos urbanos del momento. Los intramuros urbanos, constituidos por calles flexibles con formas dinámicas, en algunas ciudades fueron peatonalizados y se crearon distintas soluciones de movilidades urbanas eco-friendly. El urbanismo ecológico emergió para crear soluciones sostenibles urbanas solventando las diferentes contaminaciones que dañaban la envolvente de la ciudad, esto se produjo después de la crisis de principio del siglo XXI con el auge inmobiliario. En algunas ciudades europeas desarrollan redes de transportes colectivas para restringir el automóvil y utilizan el transporte ferroviario de cercanías, en otras ciudades debido a la preocupación de los centros e intramuros de las ciudades se implantó la movilidad a pie y a bicicleta, apoyada con medios de transporte intermodales. Se identificarán y caracterizarán los objetivos y se propondrán soluciones en cuanto a los sistemas de movilidad en intramuros de Pontevedra, con lo que se pretende dar respuesta al estado actual de la peatonalización total del intramuros y a su relevancia, sin olvidar los factores de causa socio-económicos que se puedan ocasionar en la implantación de la peatonalización en esta ciudad. En esta investigación se realiza un análisis del urbanismo en intramuros de la ciudad de Pontevedra desde 1950 hasta 2016 y de la implantación de la peatonalización en el mismo desde 1999 hasta la actualidad. Con base a la Teoría de la Lógica Social del Espacio, se utiliza Depthmap como herramienta de trabajo para analizar las vías de intramuros de Pontevedra. Se efectúan cuestionarios por las calles del intramuros a comerciantes y habitantes, y se realizan entrevistas a los pontevedreses Antonio de la Peña, historiador, al antropólogo Buenaventura Aparicio Casado y al arquitecto César Portela. El análisis de tipología de usos edificatorios, tanto en el perímetro como en el intramuros de Pontevedra, muestra las dinámicas sociales relacionadas a las actividades socio-económicas implantadas actualmente y el funcionamiento de la peatonalización, dichas actividades muestran cuáles son las calles con mayores flujos dinámicos. La teoría de la Sintaxis Espacial muestra la configuración del trazado urbano en la que se identifica el sistema y la distribución, el uso de suelo y la accesibilidad. La herramienta Space Syntax analiza y valora las distintas escalas en la estructura urbana e intenta buscar la integración del espacio del intramuros de Pontevedra. En la conclusión se elabora una reflexión de todos los análisis de la investigación y su sistematización, en donde se desarrollan soluciones con interpretaciones personales que afectan a algunas zonas del intramuros, manteniendo la estructura urbana del intramuros y creando posibles soluciones con una visión general del conjunto territorial.Abstract: In the late twentieth century, pedestrian malls were practical solutions to the most damaging urban problems, solving the socio-economic and urban conflicts of the time. The areas within city walls, consisting of flexible streets with dynamic forms, were turned into pedestrian zones in some cities and different eco-friendly urban mobility solutions were achieved. Environmentally friendly urban planning emerged to create sustainable solutions by solving the various pollution issues that damaged the envelope of the city; this came about after the crisis of the early twenty-first century caused by the housing boom. Some European cities developed networks of public transport to restrict the use of the car and encourage the use of mass-rapid transport by rail; in other cities, because of concerns related to the city centres and walls, urban mobility on foot and bicycle was introduced, supported by intermodal transport means. The objectives will be identified and characterized and solutions will be proposed in relation to mobility systems within the city walls of Pontevedra, aimed at providing answers to the current state of the total pedestrianisation within the city walls and its relevance, without forgetting the socio-economic factors of cause that can be caused in the implantation of the pedestrianization in this city. This research analyses urban planning within the city walls of Pontevedra from 1950 to 2016 and its pedestrianisation from 1999 to present. Based on the Theory of Social Logic of Space, Depthmap has been used as a tool to analyse the streets within the city walls of Pontevedra. Questionnaires were answered by merchants and residents within the city walls, and interviews were conducted with several Pontevedra residents: historian Antonio de la Peña, anthropologist Buenaventura Casado Aparicio and architect César Portela. The analysis of the type of building strategies, both around the perimeter and within the city walls of Pontevedra, shows the social dynamics related to the socio-economic activities currently implemented, as well as the functioning of pedestrianisation; these activities show the streets with higher dynamic flows. Space Syntax theory shows the configuration of urban design identifying the system and distribution, land use and accessibility. The Space Syntax tool analyses and evaluates the different scales in the urban structure and attempts to achieve space integration within the city walls of Pontevedra. The conclusion reflects on all the research analyses and their systematisation, where solutions are developed with personal interpretations affecting some areas of the city walls, keeping the urban structure of the city walls and achieving possible solutions with an overview of the territorial whole

Asistencia sanitaria y salud pública en Talavera de la Reina durante la Guerra Civil (1936-1939)

This work aims to comprehensively analyse the effects of the Spanish civil war on the population and the sanitary services of Talavera de la Reina, a key city in the development of the contest due to its geographic location between Andalusia Western, Extremadura and Madrid. To this end, he has worked with documentation of the Municipal Archives of Talavera de la Reina, the archive of the secondary Centre of Rural hygiene in Talavera de la Reina, the Provincial historical archive of Toledo and the military general archive of Ávila. First, appears the Group of five military hospitals that operated in the city, its organization and activity, reconstructed from different models used chips. Preventive activity is analysed from two points of view, the orders emanating from the military authority, with a focus on hygiene, food and prevention of infectious diseases, and the actions carried out by the local authorities, centred ensure a proper water supply and waste collection. In addition, exposed the unhealthy situation in prisons in the city, is a clear example of the State of the health of the moment.El presente trabajo pretende analizar de forma integrada los efectos de la guerra civil española sobre la población y los servicios sanitarios de Talavera de la Reina, ciudad clave en el desarrollo de la contienda debido a su ubicación geográfica entre Andalucía occidental, Extremadura y Madrid. Para ello, se ha trabajado con documentación del Archivo Municipal de Talavera de la Reina, del Archivo del Centro Secundario de Higiene Rural de Talavera de la Reina, del Archivo Histórico Provincial de Toledo y del Archivo General Militar de Ávila. En primer lugar, se presenta el grupo de cinco hospitales militares que funcionaron en la ciudad, su organización y actividad, reconstruida a partir de los diferentes modelos de fichas utilizadas. La actividad preventiva se analiza desde dos puntos de vista, las órdenes emanadas de la autoridad militar, centradas en la higiene, alimentación y prevención de enfermedades infecciosas, y las actuaciones llevadas a cabo por las autoridades locales, centradas en asegurar un correcto abastecimiento de agua y recogida de residuos. Además, se expone la situación insalubre de las prisiones de la ciudad, siendo un claro ejemplo del estado sanitario del momento

Amyand’s Hernia. Case report and literature review

Las hernias inguinales constituyen una de las entidades más frecuentes en cirugía. La localización de una apendicitis en el seno de una hernia inguinal, se conoce como hernia de Amyand, una patología poco frecuente, en torno al 0,13%, que requiere de un tratamiento quirúrgico urgente. A continuación se presenta el caso de un paciente con una hernia de Amyand, su clínica y diagnóstico con el objetivo de exponer su actitud terapéutica.Inguinal hernias are one of the most frequent pathologies in surgery. The location of an appendicitis in an inguinal hernia is known as Amyand's hernia, a rare condition, around 0.13%, which requires urgent surgical treatment. We present the case of a patient with a hernia of Amyand, the clinic and diagnosis with the aim of exposing his therapeutic attitude

Study surgical treatment of early closing of ileostomy in rectal cancer: impact on the quality of life, morbidity and mortality and health spending

Introducción: Los pacientes sometidos a cirugía de recto con anastomosis bajas y que portan ileostomías de protección, ven prolongado el intervalo entre la realización del estoma y la cirugía de reconstrucción a veces durante meses, mientras dure el tratamiento adyuvante. El objetivo de este estudio es valorar el impacto de la calidad de vida, modificaciones en la morbimortalidad y el gasto sanitario ante el cierre de la ileostomía previo al tratamiento adyuvante. Material y métodos: Revisión retrospectiva. Se analizaron los pacientes sometidos a cierre de ileostomía entre enero 2012 y diciembre de 2013. El número de pacientes estudiado ha sido de 55: 41 varones (74,54%) y 14 mujeres (25,45%). En 27 pacientes se realizó cierre de ileostomía al año de su creación y en 28 al mes. En ambos grupos se analizó la morbimortalidad, coste sanitario y calidad de vida, este último parámetro mediante la aplicación del cuestionario GIQLI de calidad de vida. Resultados: El número de pacientes estudiado es 55. La edad media 63,83 años. Los pacientes con cierre precoz de ileostomía presentaron una estancia media hospitalaria menor, 11,87 días respecto a los pacientes con cierre anual, 14,96 días, descendiendo así el coste sanitario. El 18,33 % de los pacientes con cierre precoz de ileostomía presentó íleo postoperatorio frente a un 65,3% del cierre tardío. La calidad de vida (bienestar total) valorada en pacientes con cierre precoz ha sido de un 61, 2% frente a un 33,44 % en pacientes con cierre tardío. Conclusiones: La realización de ileostomías de protección en las anastomosis rectales bajas ha demostrado ser una medida preventiva eficaz para disminuir la morbimortalidad de las dehiscencias de las mismas. El cierre precoz de la ileostomía reduce el íleo postoperatorio, la estancia media hospitalaria, mejora la calidad de vida y el coste sanitario.Introduction: Patients undergoing rectal surgery with low anastomosis and carrying ileostomy protection, can see extended the interval between placing the stoma and the reconstructive surgery, sometimes during months, while the adjuvant treatment is being developed. The aim of this study was to assess the impact on the Quality of Life, changes in morbidity and mortality and health costs before the closure of the ileostomy prior to the adjuvant treatment. Material and methods: Retrospective study. 55 patients underwent closure of the ileostomy between January 2012 and December 2013 were studied. The sample consisted on 41 (74.54%) men and 14 (25.45%) women. In 27 Patients the closure of the ileostomy was performed in 1 year from its creation and in 28 patients was closed in one month. Morbidity and mortality, medical cost and Quality of Life were analyzed. Results: The average age was 63.83 years. Patients with early closure of ileostomy had a mean hospital stay lower, 11.87 days compared to patients with annual closure, 14.96 days, and so descending health costs. 18, 33% of patients with early closure of ileostomy presented postoperative ileus against the 65.3% of late closure. Quality of Life in Patients with early closure has been assessed 61, 2% compared to 33.44% in patients with late closure. Conclusions: Performing protection ileostomy in low rectal anastomosis has proven to be a preventive effective measure in reducing morbidity and mortality dehiscence. Early closure of the ileostomy reduces postoperative ileus, the average of hospital stay, and improves quality of life and health costs

Multidisciplinary Prehabilitation and Postoperative Rehabilitation for Avoiding Complications in Patients Undergoing Resection of Colon Cancer: Rationale, Design, and Methodology of the ONCOFIT Study

ONCOFIT is a randomized clinical trial with a two-arm parallel design aimed at determining the influence of a multidisciplinary Prehabilitation and Postoperative Program (PPP) on post-surgery complications in patients undergoing resection of colon cancer. This intervention will include supervised physical exercise, dietary behavior change, and psychological support comparing its influence to the standard care. Primary and secondary endpoints will be assessed at baseline, at preoperative conditions, at the end of the PPP intervention (after 12 weeks) and 1-year post-surgery, and will include: post-surgery complications (primary endpoint); prolonged hospital length of stay; readmissions and emergency department call within 1-year after surgery; functional capacity; patient reported outcome measures targeted; anthropometry and body composition; clinical/tumor parameters; physical activity levels and sedentariness; dietary habits; other unhealthy habits; sleep quality; and fecal microbiota diversity and composition. Considering the feasibility of the present intervention in a real-life scenario, ONCOFIT will contribute to the standardization of a cost-effective strategy for preventing and improving health-related consequences in patients undergoing resection of colon cancer with an important clinical and economic impact, not only in the scientific community, but also in clinical practice.This study was funded by the University of Granada, Plan Propio de Investigación 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES). P.C. was supported by the Margarita Salas postdoctoral grant, convened by de University of the Basque Country (UPV/EHU), funded by the Ministry of Universities of Spain and the European Union-Next Generation EU

Current surgical techniques in rectal cancer

El cáncer de recto es actualmente una de las enfermedades que implican una mayor morbimortalidad en la sociedad, tanto para la persona que lo sufre como para la esfera que lo rodea. La evolución en este tipo de tumores permiten abandonar el concepto clásico de grandes incisiones y extensas resecciones, para acercarnos al abordaje mínimamente invasivo, y a realizar la resección que sea únicamente necesaria, buscando preservar la integridad esfintérica en el paciente, y tratando de evitar en la medida de lo posible la confección de ostomías. La mayoría de las investigaciones que se realizan sobre el cáncer de recto, van encaminadas a la mejora en los tratamientos complementarios a la cirugía, como los tratamientos quimioterápicos neoadyuvantes, y los fármacos posteriores a la cirugía, es decir, la quimioterapia adyuvante. Únicamente un tercio de los estudios que se llevan a cabo son para mejorar la técnica quirúrgica. En este apartado, la aparición de la cirugía laparoscópica, el uso de dispositivos a través de orificios naturales para realizar cirugía local, la aparición de la cirugía combinada TaTME, y el auge de la cirugía robótica, parecen ser la antesala de lo que se desarrollará en un futuro respecto a las mejoras quirurgicas. En esta revisión, queremos poner de manifiesto un resumen del tratamiento quirúrgico del cáncer de recto, haciendo especial hincapié en las nuevas técnicas y avances, con una breve reseña histórica y anatómica, sin olvidar la importancia y seguridad para el paciente, tanto en la misma cirugía, como en los resultados oncológicos posteriores.Rectal cancer is currently one of the diseases that imply greater morbidity and mortality in society, both for people suffering and for the people around. The evolution in this type of tumors allows us to leave the classic concept of large incisions and extensive resections towards the minimally invasive approach, and to perform the resection that is only necessary, seeking to preserve the sphincteric integrity in the patient, and trying to avoid as much as possible ostomies. Most of rectal cancer research is aimed to improving complementary treatments to surgery, such as neoadjuvant chemotherapeutic treatments, and post-surgery drugs. Only one third of the studies carried out are focused on improvig the surgical technique. In this section, the appearance of laparoscopic surgery, the use of devices through natural holes to perform local surgery, the appearance of TaTME combined surgery, and the rise of robotic surgery, seem to be the prelude to what will be developed. in the future regarding surgical improvements. In this review, we want to highlight a summary of the surgical treatment of rectal cancer, with special emphasis on new techniques and advances and also a brief historical and anatomical review, also including the importance and safety for the patient both in the surgery and subsequent cancer follow-up

Shift work and colorectal cancer risk in the MCC-Spain case-control study

Objectives Shift work that involves circadian disruption has been associated with a higher cancer risk. Most epidemiological studies to date have focused on breast cancer risk and evidence for other common tumors is limited. We evaluated the risk for colorectal cancer (CRC) in relation to shift work history in a population-based case-control study in Spain. Methods This analysis included 1626 incident CRC cases and 3378 randomly selected population controls of both sexes, enrolled in 11 regions of Spain. Sociodemographic and lifestyle information was assessed in face-to-face interviews. Shift work was assessed in detail throughout lifetime occupational history. We estimated the risk of colon and rectal cancer associated with rotating and permanent shift work (ever, cumulative duration, age of first exposure) using unconditional logistic regression analysis adjusting for potential confounders. Results Having ever performed rotating shift work (morning, evening and/or night) was associated with an increased risk for CRC [odds ratio (OR) 1.22, 95% confidence interval (95% CI) 1.04-1.43], as compared to day workers. Having ever worked permanent night shifts (?3 nights/month) was not associated with CRC risk (OR 0.79, 95% CI 0.62-1.00). OR increased with increasing lifetime cumulative duration of rotating shift work (P-value for trend 0.005) and were highest among subjects in the top quartiles of exposure (3 rdquartile, 20-34 years, OR 1.38, 95%CI 1.06-1.81; 4 thquartile, ?35 years, OR 1.36, 95% CI 1.02-1.79). Conclusions These data suggest that rotating shift work may increase the risk of CRC especially after long-term exposures

Actividades de producción digital destinadas al conocimiento del problema de los supernumerarios a partir de fotografías e imágenes clínicas

Memoria ID-0061. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015

Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

Introduction: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Methods: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. Discussion: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.The study was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150), by the Fundación Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consortium CLL, by the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571), by the Conselleria de Sanitat of the Generalitat Valenciana (AP 061/10), by the Recercaixa (2010ACUP 00310), by the Regional Government of the Basque Country by European Commission grants FOOD-CT- 2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the The Catalan Government DURSI grant 2009SGR1489

Investigación joven con perspectiva de género

Libro de Actas del I Congreso de jóvenes investigadorxs con perspectiva de género celebrado en la Universidad Carlos III de Madrid, Getafe, 16 y 17 de junio de 2016