Workshop on new strategies and tools for the eHealth library organized by the Andalusian eHealth Library

The Andalusian eHealth Library (Biblioteca Virtual del Sistema Sanitario Publico de Andalucia, BV-SSPA), was created in June 2006. The 42 librarians who already worked for the Health System were integrated within this new system. The annual library meeting has been held every year since then, and in 2013 the EAHIL workshop held in Stockholm was the model to follow

Can the pyruvate: ferredoxin oxidoreductase (PFOR) gene be used as an additional marker to discriminate among Blastocystis strains or subtypes?

Background Blastocystis spp. are the most prevalent intestinal eukaryotes identified in humans, with at least 17 genetic subtypes (ST) based on genes coding for the small-subunit ribosomal RNA (18S). It has been argued that the 18S gene should not be the marker of choice to discriminate between STs of these strains because this marker exhibits high intra-genomic polymorphism. By contrast, pyruvate:ferredoxin oxidoreductase (PFOR) is a relevant enzyme involved in the core energy metabolism of many anaerobic microorganisms such as Blastocystis, which, in other protozoa, shows more polymorphisms than the 18S gene and thus may offer finer discrimination when trying to identify Blastocystis ST. Therefore, the objective of the present study was to assess the suitability of the PFOR gene as an additional marker to discriminate among Blastocystis strains or subtypes from symptomatic carrier children. Methods Faecal samples from 192 children with gastrointestinal symptoms from the State of Mexico were submitted for coprological study. Twenty-one of these samples were positive only for Blastocystis spp.; these samples were analysed by PCR sequencing of regions of the 18S and PFOR genes. The amplicons were purified and sequenced; afterwards, both markers were assessed for genetic diversity. Results The 18S analysis showed the following frequencies of Blastocystis subtypes: ST3 = 43%; ST1 = 38%; ST2 = 14%; and ST7 = 5%. Additionally, using subtype-specific primer sets, two samples showed mixed Blastocystis ST1 and ST2 infection. For PFOR, Bayesian inference revealed the presence of three clades (I-III); two of them grouped different ST samples, and one grouped six samples of ST3 (III). Nucleotide diversity (π) and haplotype polymorphism (θ) for the 18S analysis were similar for ST1 and ST2 (π = ~0.025 and θ = ~0.036); remarkably, ST3 showed almost 10-fold lower values. For PFOR, a similar trend was found: clade I and II had π = ~0.05 and θ = ~0.05, whereas for clade III, the values were almost 6-fold lower. Conclusions Although the fragment of the PFOR gene analysed in the present study did not allow discrimination between Blastocystis STs, this marker grouped the samples in three clades with strengthened support, suggesting that PFOR may be under different selective pressures and evolutionary histories than the 18S gene. Interestingly, the ST3 sequences showed lower variability with probable purifying selection in both markers, meaning that evolutionary forces drive differential processes among Blastocystis STs

Factores generadores de estrés percibidos por estudiantes de enfermería en sus primera práctica clínica.

Background.  Starting for the first time the university clinical practice may affect the well-being of nursing students in different situations. Hence the importance of knowing the factors causing stress at the beginning of their formative practices. Objective. To describe the factors generating stress in nursing students during their first clinical practice and its relation with sociodemographic variables. Cartagena 2017. Methods. The sample supported 108 students of nursing programs from three institutions of higher education (IES N°1, N°2 y N°3), the KEZKAK questionnaire was used to measure nursing students' stressors in clinical practice (semesters 3 to 5).  Results.Students under 22 years old (80,5%) and female gender (88,9%) principally constituted the sample. The (22.2%) of students are from IES N°1, (30,6%) from IES N°2 and (47,2%) belong to IES N°3. The factors that generated the most stress were: academic overload (88%), and emotional involvement with the patient (81,3%). The principal association of variables was: "relationship with teachers" linked both to university items (p-value = 0,002) and to semester (p-value = 0,006). Conclusions.The major factors generating stress influences the treatment with the patient. This gives an insight to the reality faced by the student in his first clinical practice: the preoccupation for their performing in activities during the training, and not being able to offer the proper care with objectivity.Introducción: el inicio de las prácticas clínicas universitarias genera en los estudiantes de enfermería diversas situaciones que pueden afectar su bienestar. De aquí la importancia de conocer los factores que causan estrés al inicio de las prácticas formativas.Objetivo: describir los factores generadores de estrés en estudiantes de Enfermería en primeras prácticas clínicas y su relación con las variables sociodemográficas. Cartagena. 2017. Materiales y métodos: estudio cuantitativo, descriptivo, de corte transversal y correlacional. La muestra correspondió a 108 estudiantes de los programas de enfermería de tres instituciones de educación superior (IES N°1, N°2 y N°3), se empleó el cuestionario KEZKAK de valoración de estresores en estudiantes de enfermería que se encuentran en prácticas clínicas (semestres 3° a 5°).Resultados: los estudiantes se distinguieron por ser en general, menores de 22 años (80,5%), género femenino (88,9%). El 22,2% pertenecen a la IES N°1, el 30,6% a IES N°2 y 47,2% a IES N°3. Los factores que generaron mayor estrés fueron: la sobrecarga académica (88%) y la implicación emocional con el paciente (81,3%). La asociación de variables relevante fue: “relación con docentes” vinculado tanto con ítem IES (valor-p = 0,002) y semestre (valor-p = 0,006). Conclusión: los factores generadores de estrés sobresalientes influyen en el trato con el paciente. Esto permite relacionar la representación esquemática de la realidad que genera en el estudiante enfrentarse a su primera práctica clínica: preocupación por tener un bajo rendimiento en actividades realizadas durante la práctica y no ofrecer cuidados específicos con la objetividad requerida

Cell wall proteins: a new insight through proteomics

Cell wall proteins are essential constituents of plant cell walls; they are involved in modifications of cell wall components, wall structure, signaling and interactions with plasma membrane proteins at the cell surface. The application of proteomic approaches to the cell wall compartment raises important questions: are there technical problems specific to cell wall proteomics? What kinds of proteins can be found in Arabidopsis walls? Are some of them unexpected? What sort of post-translational modifications have been characterized in cell wall proteins to date? The purpose of this review is to discuss the experimental results obtained to date using proteomics, as well as some of the new questions challenging future research

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks