Are iodophor-impregnated drapes associated with lower intraoperative contamination compared to no adhesive drape?: A protocol for systematic review and meta analysis

Background:Surgical site infection (SSI) is one of the most frightening complications after surgery. Adhesive drapes (AD) are widely used as an infection prevention tool. They can be non-impregnated or iodophor-impregnated, although non-impregnated are less used as they might be related to higher number of infections. One of the most common ways to study their efficacy is by analyzing the intraoperative contamination, which is a useful primary endpoint as it does not need follow-up and it has been strongly associated with infections. Therefore, we believe a systematic review (SR) and meta-analysis is needed to determine which is the literature available about this topic and to explore their results. Methods:All randomized controlled trials (RCT) published since 1984 through to January 15, 2023 will be included. Non-human and experimental studies will be excluded. We will only include studies written in English. We will conduct searches in the following electronic databases: MEDLINE (via PubMed), SCOPUS and Web Of Science. The protocol of the SR was registered in PROSPERO under the number CRD42023391651 and was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol guidelines. Discussion:The evidence regarding the benefits of using iodophor-impregnated adhesive drapes (IIAD) is scarce. Therefore, this SR and meta-analysis is required to determine if they are related with a lower intraoperative contamination incidence, compared to no AD

The needs of the metropolitan population from the residential areas: the socio-environmental endowments: housing, equipment and green spaces

Entender las necesidades de la población, de vivienda y otras dotaciones desde la lógica territorial del urbanismo, debe servir para establecer propuestas de crecimiento y rehabilitación en base a un uso eficiente del suelo. El Área Metropolitana de Barcelona está compuesta por 36 municipios, donde se entremezclan múltiples identidades que deben compartir la misma consciencia metropolitana. La aceptación del valor de esta complejidad realza aquello que es específico y singular, y permite preservarlo. El PDU apuesta por una mirada inclusiva, a partir del conocimiento de las necesidades de la población metropolitana en cuanto a equipamientos, espacios verdes o vivienda, en un territorio que tienda al equilibrio funcional y a la continuidad física. La intervención en estos aspectos debe conducirnos a una sociedad más cohesionada, equitativa y segura. Estas necesidades se concretan a partir de la diagnosis de los asentamientos urbanos, donde los ciudadanos desarrollan sus funciones cotidianas en base a cuatro aspectos fundamentales: la forma urbana, la función, la situación relativa y el rol metropolitano. Esta ponencia se centra en: • La caracterización de los tejidos residenciales del área metropolitana de Barcelona. • La diagnosis de las necesidades de la población metropolitana: las dotaciones socioambientales. • Los retos metropolitanos en materia de vivienda.Understanding housing and facilities needs from the territorial logic of urban planning, must lead us to establish proposals for new developments and renovation projects based on efficient use of land. The Barcelona Metropolitan Area is composed by 36 municipalities with multiple particular identities which must share the same metropolitan awareness. Accepting the value of this complexity enhances what is specific and unique, and allows it to be preserved. The Metropolitan Urban Master Plan (PDU) is committed to an inclusive urban perspective based on a deep knowledge of the metropolitan popula- tion’s needs regarding facilities, green spaces or housing, evolving towards a territorial functional balance and physical continuity. Intervention in these matters must lead us to increase social cohesion and to build a more equitable and secure society. These population needs are determined through a deep diagnosis of urban settlements, where citizens carry out their daily life. In the case of the metropolitan area, the following factors should to be taken into account: the urban form, the function, the relative situation and the metropolitan role. This paper focus on: • The characterization of the residential fabrics of the metropolitan area of Barcelona. • The diagnosis of the metropolitan population’s needs: the socio-environmental provisions.Peer Reviewe

Metropolitan population’s needs from residential fabrics: socio-environmental provisions: housing, facilities and green spaces

El problema del acceso a la vivienda es una de las principales preocupaciones de los ciudadanos y también una de las causas de la segregación urbana, en relación con la distribución de la población en el territorio. Entender las necesidades de vivienda desde la lógica territorial del urbanismo debe servir para establecer propuestas de crecimiento y rehabilitación en base a un uso eficiente del suelo. El Área Metropolitana de Barcelona está compuesta por 36 municipios, donde se entremezclan múltiples identidades que deben compartir la misma consciencia metropolitana. La aceptación del valor de esta complejidad realza aquello que es específico y singular, y permite preservarlo. El PDU apuesta por una mirada inclusiva, a partir del conocimiento de las necesidades de la población metropolitana en cuanto a equipamientos, espacios verdes o vivienda, en un territorio que tienda al equilibrio funcional y a la continuidad física. La intervención en estos aspectos debe conducirnos a una sociedad más cohesionada, equitativa y segura. Estas necesidades se concretan a partir de la diagnosis de los asentamientos urbanos, donde los ciudadanos desarrollan sus funciones cotidianas en base a cuatro aspectos fundamentales: la forma urbana, la función, la situación relativa y el rol metropolitano. Esta ponencia se centra en: La caracterización de los tejidos residenciales del área metropolitana de Barcelona. La diagnosis de las necesidades de la población metropolitana: las dotaciones socioambientales. Los retos metropolitanos en materia de vivienda.Affordability and access to housing is one of the main citizen concerns and also one of the causes of spatial segregation, in relation to the distribution of the population on the territory. Understanding housing needs from the territorial logic of urban planning, must lead us to establish proposals for new developments and renovation projects based on efficient use of land. The Barcelona Metropolitan Area is composed by 36 municipalities with multiple particular identities which must share the same metropolitan awareness. Accepting the value of this complexity enhances what is specific and unique, and allows it to be preserved. The Metropolitan Urban Master Plan (PDU) is committed to an inclusive urban perspective based on a deep knowledge of the metropolitan population’s needs regarding facilities, green spaces or housing, evolving towards a territorial functional balance and physical continuity. Intervention in these matters must lead us to increase social cohesion and to build a more equitable and secure society. These population needs are determined through a deep diagnosis of urban settlements, where citizens carry out their daily life. In the case of the metropolitan area, the following factors should to be taken into account: the urban form, the function, the relative situation and the metropolitan role. This paper focus on: The characterization of the residential fabrics of the metropolitan area of Barcelona. The diagnosis of the metropolitan population’s needs: the socio-environmental provisions. The metropolitan challenges regarding housing

Repair of Mitral Prolapse: Comparison of Thoracoscopic Minimally-invasive and Conventional Approaches

Objectives: Surgical repair remains the best treatment for severe primary mitral regurgitation (MR). Minimally invasive mitral valve surgery is being increasingly performed, but there is a lack of solid evidence comparing thoracoscopic with conventional surgery. Our objective was to compare outcomes of both approaches for repair of leaflet prolapse. Methods: All consecutive patients undergoing surgery for severe MR due to mitral prolapse from 2012 to 2020 were evaluated according to the approach used. Freedom from mortality, reoperation and recurrent severe MR were evaluated by Kaplan-Meier method. Differences in baseline characteristics were adjusted with propensity score-matched analysis (1:1, nearest neighbour). Results: Three hundred patients met inclusion criteria and were divided into thoracoscopic (N = 188) and conventional (sternotomy; N = 112) groups. Unmatched patients in the thoracoscopic group were younger and had lower body mass index, New York Heart Association class and EuroSCORE II preoperatively. After matching, thoracoscopic group presented significantly shorter mechanical ventilation (9 vs 15 h), shorter intensive care unit stay (41 vs 65 h) and higher postoperative haemoglobin levels (11 vs 10.2 mg/dl) despite longer bypass and cross-clamp times (+30 and +17 min). There were no differences in mortality or MR grade at discharge between groups nor differences in survival, repair failures and reinterventions during follow-up. Conclusions: Minimally invasive mitral repair can be performed in the majority of patients with mitral prolapse, without compromising outcomes, repair rate or durability, while providing shorter mechanical ventilation and intensive care unit stay and less blood loss

Thoracoscopic vs. catheter ablation for atrial fibrillation: long-term follow-up of the FAST randomized trial

Aims: Our objectives were to compare effectiveness and long-term prognosis after epicardial thoracoscopic atrial fibrillation (AF) ablation vs. endocardial catheter ablation, in patients with prior failed catheter ablation or high risk of failure. Methods and results: Patients were randomized to thoracoscopic or catheter ablation, consisting of pulmonary vein isolation with optional additional lines (2007–2010). Patients were reassessed in 2016/2017, and those without documented AF recurrence underwent 7-day ambulatory electrocardiography. The primary rhythm outcome was recurrence of any atrial arrhythmia lasting >30 s. The primary clinical endpoint was a composite of death, myocardial infarction, or cerebrovascular event, analysed with adjusted Cox proportional hazard ratios (HRs). One hundred and 24 patients were randomized with 34% persistent AF and mean age 56 years. Arrhythmia recurrence was common at mean follow-up of 7.0 years, but substantially lower with thoracoscopic ablation: 34/61 (56%) compared with 55/63 (87%) with catheter ablation [adjusted HR 0.40, 95% confidence interval (CI) 0.25–0.64; P < 0.001]. Additional ablation procedures were performed in 8 patients (13%) compared with 31 (49%), respectively (P < 0.001). Eleven patients (19%) were on anti-arrhythmic drugs at end of follow-up with thoracoscopy vs. 24 (39%) with catheter ablation (P = 0.012). There was no difference in the composite clinical outcome: 9 patients (15%) in the thoracoscopy arm vs. 10 patients (16%) with catheter ablation (HR 1.11, 95% CI 0.40–3.10; P = 0.84). Pacemaker implantation was required in 6 patients (10%) undergoing thoracoscopy and 3 (5%) in the catheter group (P = 0.27). Conclusion: Thoracoscopic AF ablation demonstrated more consistent maintenance of sinus rhythm than catheter ablation, with similar long-term clinical event rates

Proporción de carga asistencial generada por la diabetes mellitus en las consultas de enfermería de atención primaria de salut

Objetivo La mayoría de enfermos con diabetes mellitus tipo 2 (DM2) se controla en atención primaria de salud (APS). La atención y educación proporcionadas por enfermería son clave para controlar la glucemia y prevenir las complicaciones macro y microangiopáticas de la DM. El objetivo de este trabajo es conocer la proporción de carga asistencial atribuible a la DM en consultas de enfermería de APS. Material y método Estudio observacional, analítico y transversal. Durante 2 semanas consecutivas se registraron datos de todos los enfermos que acudieron a 15 consultas de enfermería de APS ubicadas en 14 Áreas Básicas de Salud (ABS) de la provincia de Barcelona. Las variables de estudio fueron: edad, sexo, situación laboral, motivo de consulta, duración de la visita, presencia de DM y, en los enfermos diabéticos, el tipo de tratamiento. La recogida de datos se realizó en 2 períodos. El primero entre noviembre del año 2003 y enero del 2004 y el segundo en abril de 2005. Se realizó un análisis descriptivo de estas variables con un intervalo de confianza del 95% y la asociación entre variables mediante el programa SPSS v.11.1. Resultados Tenía DM el 29% de los pacientes. La DM es el primer motivo de consulta (29,1%), aumenta con la edad y llega al 40% en mayores de 65 años. La duración media de una visita por DM es de 14,59 min, un 30,8% más elevada que la duración media del resto de los problemas de salud. Globalmente, las mujeres consultan más que los varones (56,6%) excepto en DM, curas y hábito tabáquico. Conclusiones La DM es el problema de salud que genera más demanda y consume más tiempo de enfermería en la APS. Esta realidad y el futuro que se prevé con relación al incremento de la prevalencia de DM exigen considerar nuevas estrategias organizativas y formativas, y establecer criterios para mejorar la gestión de recursos y promover estrategias educativas más efectivas

REBISALUD: la red de bibliotecas virtuales de salud

Rebisalud; Cooperació bibliotecària; Biblioteques virtuals de ciències de la salutRebisalud; Cooperación bibliotecaria; Bibliotecas virtuales de ciencias de la saludRebisalud; Library cooperation; Virtual libraries of health sciencesLa Red de Bibliotecas Virtuales de Salud - REBISALUD, como red que integra a 9 bibliotecas virtuales de salud de ámbito autonómico (Andalucía, Aragón, Islas Baleares, Canarias, Cataluña, Comunidad Valenciana, Región de Murcia, Comunidad Foral de Navarra y País Vasco), surge con la misión de potenciar la cooperación entre ellas, mediante la coordinación y elaboración de distintas estrategias y proyectos de colaboración conjuntos, encaminados a optimizar la difusión y el intercambio de la información en el ámbito de la salud

Natural and Undetermined Sudden Death: Value of Post-Mortem Genetic Investigation

Background: Sudden unexplained death may be the first manifestation of an unknown inherited cardiac disease. Current genetic technologies may enable the unraveling of an etiology and the identification of relatives at risk. The aim of our study was to define the etiology of natural deaths, younger than 50 years of age, and to investigate whether genetic defects associated with cardiac diseases could provide a potential etiology for the unexplained cases. Methods and Findings: Our cohort included a total of 789 consecutive cases (77.19% males) <50 years old (average 38.6±12.2 years old) who died suddenly from non-violent causes. A comprehensive autopsy was performed according to current forensic guidelines. During autopsy a cause of death was identified in most cases (81.1%), mainly due to cardiac alterations (56.87%). In unexplained cases, genetic analysis of the main genes associated with sudden cardiac death was performed using Next Generation Sequencing technology. Genetic analysis was performed in suspected inherited diseases (cardiomyopathy) and in unexplained death, with identification of potentially pathogenic variants in nearly 50% and 40% of samples, respectively. Conclusions: Cardiac disease is the most important cause of sudden death, especially after the age of 40. Close to 10% of cases may remain unexplained after a complete autopsy investigation. Molecular autopsy may provide an explanation for a significant part of these unexplained cases. Identification of genetic variations enables genetic counseling and undertaking of preventive measures in relatives at risk

Jardins per a la salut

Facultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia. Assignatura: Botànica farmacèutica. Curs: 2014-2015. Coordinadors: Joan Simon, Cèsar Blanché i Maria Bosch.Els materials que aquí es presenten són el recull de les fitxes botàniques de 128 espècies presents en el Jardí Ferran Soldevila de l’Edifici Històric de la UB. Els treballs han estat realitzats manera individual per part dels estudiants dels grups M-3 i T-1 de l’assignatura Botànica Farmacèutica durant els mesos de febrer a maig del curs 2014-15 com a resultat final del Projecte d’Innovació Docent «Jardins per a la salut: aprenentatge servei a Botànica farmacèutica» (codi 2014PID-UB/054). Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pels professors de l’assignatura. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica. També s’ha pretès motivar els estudiants a través del retorn de part del seu esforç a la societat a través d’una experiència d’Aprenentatge-Servei, deixant disponible finalment el treball dels estudiants per a poder ser consultable a través d’una Web pública amb la possibilitat de poder-ho fer in-situ en el propi jardí mitjançant codis QR amb un smartphone

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation