Troponinas elevadas en Urgencias. Más allá del síndrome coronario agudo

El dolor torácico es la manifestación principal de la patología cardiovascular y uno de los motivos de consulta más frecuentes en el Servicio de Urgencias Hospitalarias (SUH). Su aparición obliga a descartar un síndrome coronario agudo (SCA), cuyo diagnóstico se basa en la clínica, el electrocardiograma y troponinas. Las troponinas son biomarcadores que se elevan específicamente en la isquemia miocárdica; sin embargo, también pueden elevarse por otras causas. De hecho, existe una proporción importante de pacientes con troponinas elevadas que no sufren un SCA. Objetivos: caracterizar a los pacientes a los que se les solicita seriación de troponinas, que resultan elevadas, y describir en profundidad a aquellos que no son diagnosticados de SCA. Material y métodos: se plantea un estudio observacional retrospectivo analítico en el que se incluyen pacientes mayores de 14 años atendidos en el SUH con una primera determinación de troponinas elevadas a los que se les realiza seriación de las mismas. Resultados: el 73% de los pacientes con elevación de troponinas no fue diagnosticado de SCA. Estos pacientes obtuvieron una puntuación media de 3,97 ± 2,52 en el índice de Charlson, reflejando una comorbilidad significativamente mayor que los pacientes que sufrieron un SCA dentro la muestra. Relativo a la evolución, un 40% de los pacientes con troponinas elevadas sin SCA fue dado de alta desde el SUH. Conclusiones: una importante proporción de los pacientes con troponinas elevadas no sufre SCA y presenta mayor índice de comorbilidad. Gran parte de estos pacientes es dada de alta.Grado en Medicin

Distributional accounts: a tool for monitoring the distribution of household wealth and debt components

Rationale This article presents annual distributions of aggregate wealth and debt components of Spanish households by income and wealth. Distributions for the period 2002 to 2020 are estimated drawing on the seven available waves of the Spanish Survey of Household Finances, while those for the latest period (2021-2022) are predictions. Takeaways •Distributional wealth and debt accounts allow us to monitor the distribution of aggregate wealth and debt among different groups of households when microeconomic data are lacking. •For the period 2020 to 2022, the model estimates that households in the bottom two quintiles of the income distribution saw their share of total housing wealth and debt for purposes other than house purchase rise, by 0.6 pp and 0.4 pp, respectively. By contrast, their share of bank deposits, shares and debt for house purchase is estimated to have fallen, by 0.2 pp, 0.1 pp and 0.3 pp, respectively. •Also for the period 2020 to 2022, the model estimates that households in the top income decile saw their share of total housing wealth and debt for purposes other than house purchase fall, by 0.5 pp and 1.1 pp, respectively, while their share of bank deposits and debt for house purchase is estimated to have risen, by 0.5 pp and 1.2 pp, respectively

Conocimiento de los comportamientos y las consecuencias de las catástrofes entre los estudiantes de psicología

It does not exist many studies on the perception that people have about behavioral consequences and psychological health of having experienced a catastrophe. However, those who have focused on it, along with this research, have found that the different groups studied present distortions about catastrophes, having topical beliefs about the occurrence of behaviors such as panic, looting, disorders, etc. Method: This study was performed with a sample of 544 psychology students and other disciplines. The design corresponds to a retrospective study or ex post facto where it has been used a scale of collective behavior in disasters and risk situations. Results: It has appeared significant differences in the mean scores between the group of psychology students regarding the correction key and in comparison with non-psychologists. Conclusions: These results could indicate that the training given to students of psychology distorts their perceptions about the occurrence of behavioral myths in catastrophes.No existen muchos estudios sobre la percepción que se tiene sobre las consecuencias comportamentales y para la salud psicológica por haber experimentado una catástrofe. Sin embargo, los que se han centrado anteriormente y esta misma investigación han encontrado que los distintos grupos estudiados presentan distorsiones sobre la misma teniendo creencias tópicas sobre la aparición de conductas como el pánico, saqueo, trastornos, etc. Método: El presente trabajo se ha realizado con 544 participantes estudiantes de psicología y de otras carreras. El diseño corresponde a un estudio retrospectivo o ex post facto en el que se ha utilizado una escala sobre comportamiento colectivo ante catástrofes y situaciones de riesgo Resultados: Han aparecido diferencias significativas de las puntuaciones medias del grupo de psicólogos respecto a las claves de corrección y el grupo de no-psicólogos. Conclusiones: Estos resultados podrían indicar que la formación que se les da a los alumnos de psicología distorsiona la percepción que tienen sobre la ocurrencia de conductas-mito en las catástrofes

Knowledge of the behaviors and consequences of catastrophes among psychology students

Background: It does not exist many studies on the perception that people have about behavioral consequences and psychological health of having experienced a catastrophe. However, those who have focused on it, along with this research, have found that the different groups studied present distortions about catastrophes, having topical beliefs about the occurrence of behaviors such as panic, looting, disorders, etc. Method: This study was performed with a sample of 544 psychology students and other disciplines. The design corresponds to a retrospective study or ex post facto where it has been used a scale of collective behavior in disasters and risk situations. Results: It has appeared significant differences in the mean scores between the group of psychology students regarding the correction key and in comparison with non-psychologists. Conclusions: These results could indicate that the training given to students of psychology distorts their perceptions about the occurrence of behavioral myths in catastrophes.La Revista Publicaciones se edita en la Facultad y cuenta con los siguientes patrocinadores: Consejería de Educación, Juventud y Deportes (Ciudad Autónoma de Melilla) Vicerrectorado de Investigación y Transferencia de la Universidad de Granada Facultad de Educación y Humanidades de Melill

Las cuentas distributivas: una herramienta para el seguimiento de la distribución de componentes de la riqueza y de la deuda de los hogares

Motivación Este artículo presenta distribuciones anuales de componentes de la riqueza y de la deuda agregadas de los hogares en España según su renta y riqueza. Entre 2002 y 2020 se estiman distribuciones a partir de las siete olas disponibles de la Encuesta Financiera de las Familias. Para el período 2021-2022 se presentan predicciones. Ideas principales •Las cuentas distributivas de riqueza y deuda permiten conocer el reparto de la riqueza y la deuda agregadas entre distintos grupos de hogares cuando se carece de información a nivel microeconómico. •Entre 2020 y 2022, el grupo de hogares de las dos quintilas inferiores de la distribución de la renta habría aumentado su participación en el total de la riqueza en vivienda (0,6 pp) y en las deudas para finalidades distintas a la adquisición de vivienda (0,4 pp). Por otra parte, este grupo habría reducido su participación en depósitos (0,2 pp), acciones (0,1 pp) y deuda para la adquisición de vivienda (0,3 pp). •Entre 2020 y 2022, los hogares de la decila superior de renta habrían reducido su participación en el total de la riqueza en vivienda (0,5 pp) y en las deudas para finalidades distintas a la adquisición de vivienda (1,1 pp), aumentando su participación en depósitos (0,5 pp) y deuda para la adquisición de vivienda (1,2 pp)

Effect of hip muscle strengthening exercises on pain and disability in patients with non-specific low back pain—a systematic review

Low back pain (LBP) is a health problem that affects 70–80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of this study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from the PubMed, PEDro, and Scopus databases published up to September 2022. Based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASP and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as “good”. In conclusion, the addition of hip muscle strengthening exercises iterating interacted with LBP, effectively improving pain and disability

Is Routine Prophylaxis Against Pneumocystis jirovecii Needed in Liver Transplantation? A Retrospective Single-Centre Experience and Current Prophylaxis Strategies in Spain

In liver transplant (LT) recipients, Pneumocystis jirovecii pneumonia (PJP) is most frequently reported before 1992 when immunosuppressive regimens were more intense. It is uncertain whether universal PJP prophylaxis is still applicable in the contemporary LT setting. We aimed to examine the incidence of PJP in LT recipients followed at our institution where routine prophylaxis has never been practiced and to define the prophylaxis strategies currently employed among LT units in Spain. All LT performed from 1990 to October 2019 were retrospectively reviewed and Spanish LT units were queried via email to specify their current prophylaxis strategy. During the study period, 662 LT procedures were carried out on 610 patients. Five cases of PJP were identified, with only one occurring within the first 6 months. The cumulative incidence and incidence rate were 0.82% and 0.99 cases per 1000 person transplant years. All LT units responded, the majority of which provide prophylaxis (80%). Duration of prophylaxis, however, varied significantly. The low incidence of PJP in our unprophylaxed cohort, with most cases occurring beyond the usual recommended period of prophylaxis, questions a one-size-fits-all approach to PJP prophylaxis. A significant heterogeneity in prophylaxis strategies exists among Spanish LT centres.Funding: This study was supported by the Health Research Institute Marqués de Valdecilla. IDIVAL. Santander. NEXT VAL17/07 grant to José Ignacio Fortea Ormaechea

aKnowledge of the behaviors and consequences of catastrophes among psychology students

It does not exist many studies on the perception that people have about behavioral consequences and psychological health of having experienced a catastrophe. However, those who have focused on it, along with this research, have found that the different groups studied present distortions about catastrophes, having topical beliefs about the occurrence of behaviors such as panic, looting, disorders, etc. Method: This study was performed with a sample of 544 psychology students and other disciplines. The design corresponds to a retrospective study or ex post facto where it has been used a scale of collective behavior in disasters and risk situations. Results: It has appeared significant differences in the mean scores between the group of psychology students regarding the correction key and in comparison with non-psychologists. Conclusions: These results could indicate that the training given to students of psychology distorts their perceptions about the occurrence of behavioral myths in catastrophes

Congestive Hepatopathy

Liver disease resulting from heart failure (HF) has generally been referred as “cardiac hepatopathy”. One of its main forms is congestive hepatopathy (CH), which results from passive venous congestion in the setting of chronic right-sided HF. The current spectrum of CH differs from earlier reports with HF, due to ischemic cardiomyopathy and congenital heart disease having surpassed rheumatic valvular disease. The chronic passive congestion leads to sinusoidal hypertension, centrilobular fibrosis, and ultimately, cirrhosis (“cardiac cirrhosis”) and hepatocellular carcinoma after several decades of ongoing injury. Contrary to primary liver diseases, in CH, inflammation seems to play no role in the progression of liver fibrosis, bridging fibrosis occurs between central veins to produce a “reversed lobulation” pattern and the performance of non-invasive diagnostic tests of liver fibrosis is poor. Although the clinical picture and prognosis is usually dominated by the underlying heart condition, the improved long-term survival of cardiac patients due to advances in medical and surgical treatments are responsible for the increased number of liver complications in this setting. Eventually, liver disease could become as clinically relevant as cardiac disease and further complicate its management