Manifestaciones neurológicas en las enfermedades autoinmunes. Análisis de una cohorte de pacientes del Hospital Universitario Río Hortega

Las enfermedades autoinmunes sistémicas se caracterizan por una presentación variada y polimorfa, afectando frecuentemente a distintos órganos y sistemas. Dentro de estas localizaciones se encuentra el sistema nervioso (SN), tanto central (SNC) como periférico (SNP), cuya afectación puede dar lugar a multitud de síndromes neurológicos superponibles a los que pueden aparecer en enfermedades con una etiología diferente. El presente trabajo busca describir la afectación neurológica de estas enfermedades tanto a nivel clínico como de imagen por resonancia magnética (RM), así como analizar su presencia en una cohorte de pacientes con enfermedades autoinmunes del Hospital Universitario Río Hortega de Valladolid (HURH). Se ha realizado un estudio observacional retrospectivo seleccionando un total de 225 pacientes a partir de una base de datos de la unidad de enfermedades autoinmunes. Las variables que se estudiaron fueron: edad, sexo, enfermedad autoinmune diagnosticada, afectación del SN (global/SNC/SNP), manifestación neurológica y alteración en la neuroimagen con RM. Se encontró afectación del sistema nervioso en 60 sujetos de la muestra estudiada, lo que se corresponde con un 26,7%. Dentro de estos, el 70% presentaba afectación del SNC, un 21,7% del SNP y el 8,3% restante a nivel de ambas localizaciones. La alteración en la neuroimagen se encontró en 27 pacientes (12%). Los resultados encontrados muestran distintos grados de coincidencia con lo publicado en la literatura sobre la prevalencia de afectación del SN y la frecuencia de las manifestaciones clinico-radiológicas por enfermedad. Dicha variabilidad puede ser inherente a la distribución de las enfermedades en la cohorte estudiada. Conocer la afectación neurológica de los pacientes con enfermedades autoinmunes sistémicas del HURH puede servir para aumentar el grado de conocimiento sobre estas manifestaciones. De esta forma, se puede lograr una mejoría en la asistencia clínica de estos enfermos por parte de profesionales que no están familiarizados con estas patologías.Grado en Medicin

Continuity of Nursing Care in Patients with Coronary Artery Disease: A Systematic Review

Coronary artery disease is the leading cause of death worldwide and patient continuity of care is essential. Health professionals can help in the transition stage by providing resources to achieve pharmacological treatment adherence, as well as social and emotional support. The objective was to analyse the effects of nursing interventions based on continuity of care in patients with coronary artery disease after hospital discharge. A systematic review of randomised controlled trials and quasi-experimental studies was carried out. Cochrane, CINAHL, Health & medical collection, Medline, and Scopus databases were consulted in January 2022. PRISMA guidelines were followed with no time limits. In total, 16 articles were included with a total of 2950 patients. Nurse-led continuity of care programs improved the monitoring and control of the disease. Positive effects were found in the quality of life of patients, and in mental health, self-efficacy, and self-care capacity dimensions. Clinical parameters such as blood pressure and lipid levels decreased. The continuity of care provided by nurses had a positive influence on the quality of life of patients with coronary artery disease. Nurse-led care focused on the needs and resources, including continuity of care, plays a key role

Daytime perimeter environmental noise in the vicinity of four hospitals in the city of Lima, Peru

The present study is intended to get to know thelevels of perimeter diurnal environmental noise of fourhospitals in the city of Lima. The measurement mode usedat each hospital was A-weighting, with an integration timeof five minutes per recording. It was measured in the FASTmode with calibrations made at the beginning and end ofthe measurement day. Statistical analysis consisted of themean comparison T test which was applied at all the hospi-tals considered in the study. At the four hospitals, at all thehours of measurement and both on working days and non-working days (Sunday), LAeq mean values are higher than83 dBA. On working days, two periods of maximum noisefrom 08:00 to 10:00 in the morning and from 17:00 to 19:00in the afternoon coincide with the start and end of workinghours. The perimeter diurnal environmental noise levelsdetermined at the vicinity of four hospitals show highervalues in all cases to those established by the Peruvian Na-tional Environmental Standards for Noise for special pro-tection areas both for working days and for non-workingdays. Noise that comes from the dense and disorganizedtraffic of Lima plays a fundamental role in this behaviou

RIED. Revista iberoamericana de educación a distancia

Resumen basado en el de la publicaciónSe presenta un Modelo Psicopedagógico para el Diseño y la Evaluación de Materiales Didácticos que incluye criterios para el diseño, la producción y la evaluación de materiales didácticos para la educación a distancia. Este modelo se sustenta en las Ciencias Cognitivas, particularmente en lo que se refiere a la promoción del aprendizaje autónomo y autorregulado en los alumnos. Dicha propuesta gira en torno a la cultura del aprendizaje permanente, en la cual se desarrollan habilidades de participación activa a través de diversos materiales didácticos. Se clasifican los materiales en tres tipos: impresos, audiovisuales y digitales.MadridES

Study protocol for investigating the clinical performance of an automated blood test for glial fibrillary acidic protein and ubiquitin carboxy-terminal hydrolase L1 blood concentrations in elderly patients with mild traumatic BRAIN Injury and reference values (BRAINI-2 Elderly European study): a prospective multicentre observational study

International audienceIntroduction:Two blood brain-derived biomarkers, glial fibrillar acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), can rule out intracranial lesions in patients with mild traumatic brain injury (mTBI) when assessed within the first 12 hours. Most elderly patients were excluded from previous studies due to comorbidities. Biomarker use in elderly population could be affected by increased basal levels. This study will assess the performance of an automated test for measuring serum GFAP and UCH-L1 in elderly patients to predict the absence of intracranial lesions on head CT scans after mTBI, and determine both biomarkers reference values in a non-TBI elderly population. Methods and analysis This is a prospective multicentre observational study on elderly patients (≥65 years) that will be performed in Spain, France and Germany. Two patient groups will be included in two independent substudies. (1) A cohort of 2370 elderly patients (1185<80 years and 1185≥80 years; BRAINI2-ELDERLY DIAGNOSTIC AND PROGNOSTIC STUDY) with mTBI and a brain CT scan that will undergo blood sampling within 12 hours after mTBI. The primary outcome measure is the diagnostic performance of GFAP and UCH-L1 measured using an automated assay for discriminating between patients with positive and negative findings on brain CT scans. Secondary outcome measures include the performance of both biomarkers in predicting early (1 week) and midterm (3 months) neurological status and quality of life after trauma. (2) A cohort of 480 elderly reference participants (BRAINI2-ELDERLY REFERENCE STUDY) in whom reference values for GFAP and UCHL1 will be determined. Ethics and dissemination Ethical approval was obtained from the Institutional Review Boards of Hospital 12 de Octubre in Spain (Re#22/027) and Southeast VI (Clermont Ferrand Hospital) (Re# 22.01782.000095) in France. The study’s results will be presented at scientific meetings and published in peer-review publications. Trial registration number NCT05425251

Study protocol for investigating the clinical performance of an automated blood test for glial fibrillary acidic protein and ubiquitin carboxy-terminal hydrolase L1 blood concentrations in elderly patients with mild traumatic BRAIN Injury and reference values (BRAINI-2 Elderly European study): a prospective multicentre observational study

Introduction Two blood brain-derived biomarkers, glial fibrillar acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), can rule out intracranial lesions in patients with mild traumatic brain injury (mTBI) when assessed within the first 12 hours. Most elderly patients were excluded from previous studies due to comorbidities. Biomarker use in elderly population could be affected by increased basal levels. This study will assess the performance of an automated test for measuring serum GFAP and UCH-L1 in elderly patients to predict the absence of intracranial lesions on head CT scans after mTBI, and determine both biomarkers reference values in a non-TBI elderly population.Methods and analysis This is a prospective multicentre observational study on elderly patients (≥65 years) that will be performed in Spain, France and Germany. Two patient groups will be included in two independent substudies. (1) A cohort of 2370 elderly patients (1185&lt;80 years and 1185≥80 years; BRAINI2-ELDERLY DIAGNOSTIC AND PROGNOSTIC STUDY) with mTBI and a brain CT scan that will undergo blood sampling within 12 hours after mTBI. The primary outcome measure is the diagnostic performance of GFAP and UCH-L1 measured using an automated assay for discriminating between patients with positive and negative findings on brain CT scans. Secondary outcome measures include the performance of both biomarkers in predicting early (1 week) and midterm (3 months) neurological status and quality of life after trauma. (2) A cohort of 480 elderly reference participants (BRAINI2-ELDERLY REFERENCE STUDY) in whom reference values for GFAP and UCHL1 will be determined.Ethics and dissemination Ethical approval was obtained from the Institutional Review Boards of Hospital 12 de Octubre in Spain (Re#22/027) and Southeast VI (Clermont Ferrand Hospital) (Re# 22.01782.000095) in France. The study’s results will be presented at scientific meetings and published in peer-review publications.Trial registration number NCT05425251