Resultados de una unidad funcional de pie diabético integrada por un podólogo y un endocrinólogo dentro del sistema nacional de salud

El Síndrome de Pie Diabético (PD) es una de las complicaciones más tardía e incapacitante de la Diabetes Mellitus (DM). Diversos posicionamientos científicos, ADA, NICE e IDF, dejan bien establecido que los pacientes con lesiones por PD y los que tienen alto riesgo para ulcerarse, deben ser atendidos por equipos multidisciplinarios. En el año 2008 en el Hospital Universitario Príncipe de Asturias de Alcalá de Henares (Madrid), se puso en funcionamiento una Consulta de Pie Diabético (CPD), atendida por un podólogo y un endocrinólogo para dar cobertura a pacientes con pie diabético. De manera progresiva se ha coordinado con distintas disciplinas implicadas formándose así, una Unidad Funcional de Pie Diabético (UFPD). En este estudio se planteo como hipótesis si la implementación de una UFPD dentro del Sistema Nacional de Salud (SNS), cuyo eje central de funcionamiento se realice por el trabajo coordinado de un podólogo y un endocrinólogo, se asocia con unos resultados favorables en la atención del paciente con PD, como son: (i) tasas de cicatrización similares a unidades de referencia en PD en Europa, (ii) reducción de la tasa de reulceración en la población atendida en la UFPD, (iii) reducción de tasas de amputación mayor en población con DM del área de salud. Para abordar los objetivos se desarrollaron dos estudios independientes pero complementarios. 1) Análisis de los pacientes atendidos en la CPD de la UFPD: se analizaron las características clínicas de la muestra de sujetos, los episodios registrados como úlceras en los pies, la reulceración de los pacientes durante el seguimiento y la mortalidad de los mismos, mediante un estudio retrospectivo de cohortes desde Marzo del 2008 a diciembre del 2014. Se incluyó una muestra final de 345 sujetos que generaron 590 episodios de ulceración. 2) Análisis de incidencia de amputaciones del miembro inferior (AMI) en población con diabetes y sin diabetes mediante un estudio retrospectivo de cohortes de las AMI de causa no traumática que ha tenido lugar en la población censada en nuestra área de salud, desde 1-1-2001 al 31-12-2014..

Positive parenting: do families use positive parenting techniques?

RESUMEN: El término parentalidad ha ido evolucionando a lo largo de los años. Hoy en día, a este término le añadimos el adjetivo positiva para referirnos al comportamiento de los padres en las labores de parentalidad, basado en el interés superior del menor, promoviendo relaciones positivas y garantizando todos los derechos del niño. La parentalidad positiva plantea el ejercicio de esta basándose en el afecto, la comunicación, el establecimiento de normas y límites, las consecuencias, el acompañamiento… (Maíquez, Martín, Rodrigo y Rodríguez, 2015). En este trabajo, se lleva a cabo una investigación sobre la información que reciben los progenitores de Cantabria con hijos menores de edad, así como las estrategias de parentalidad que estos emplean en su día a día. Para poder llevarlo a cabo, hemos empleado una muestra de 45 participantes elegida a través del muestreo no probabilístico siguiendo la técnica de la bola de nieve. La muestra seleccionada cumple dos requisitos: el primero de ellos, tener hijos menores o ser tutores legales de un menor y, el segundo y último, habitar en Cantabria. La muestra en su totalidad recibió un cuestionario, con un total de 16 preguntas, vía email en el que se planteaban dos tipos de cuestiones, unas más relacionadas con datos sociodemográficos y otras con las labores y estrategias de parentalidad. A través de este trabajo de investigación y, con los datos obtenidos de las encuestas, pudimos comprobar que un alto porcentaje de los participantes no ha recibido información ni formación acerca de la parentalidad positiva y, que en función de la situación que se estuviera dando, los progenitores emplean, o no, estrategias basadas en la parentalidad positiva. 3 Además, teniendo en cuenta la gran variedad de programas de apoyo que existen para todas las familias, tanto a nivel estatal como autonómico, deberían replantearse la accesibilidad que las familias tienen de acceder a estos, empleando nuevos canales como Youtube, Instagram… de forma, que se dé a conocer la existencia de las ayudas y apoyos que las familias pueden recibir en la ardua labor de crianza.ABSTRACT: The term parenting has evolved over the years. Nowadays, to this term we add the positive adjective to refer to the parent’s behavior, in parenting work, based on the best interests of the underage, promoting positive relationships and guaranteeing all the child’s rights. Positive parenting raises parenting tasks based on affection, communication, the establishment of norms and limits, consequences, accompaniment… (Máiquez, et al., 2015). In this work, a research work was carried out on the information received by parents of Cantabria with underage children as well as the parenting strategies that they use in their day-to-day lives. In order to carry it out, we have used a sample of 45 parents through the non-probabilistic sampling following the snowball technique. The selected sample meet two requirements: the first one, have minor children or be legal guardians of a minor and, the second and last, live in Cantabria. The entire sample received a questionnaire, with a total of 16 questions, via email in which two types of questions were posed, some more related to sociodemographic data and others related to parenting tasks and strategies. Through this research work and, with the data obtained from the surveys, we were able to verify that a high percentage of the participants have not received information or training about positive parenting and, depending on the situation, parents do or do not use strategies based on positive parenting. In addition, taking into account the great variety of support programs for all families that exist on a state and regional level, the accessibility that families have to these should be rethought, for example, using new channels such as YouTube or Instagram in order to divulge the existence of the help and support that families can receive in the arduous work of parenting.Grado en Magisterio en Educación Infanti

Enantiomeric analysis of pyrethroids and organophosphorus insecticides

The use of pesticides has increased sharply in the last decades, not only in agriculture, but also in industry, public health, and other areas. Pyrethroids and organophosphorus insecticides are among the most employed pesticides. These chemicals usually contain asymmetric chiral atoms; thus, they are characterized by stereoisomerism. Although most of these chiral pesticides are produced, used, and released as racemic mixtures, the different enantiomers of these compounds can present different insecticidal activity, different toxicity against vertebrates and invertebrates, and also different persistence in the environment. In fact, in some cases, only one enantiomer is active, while the other can be less active or even toxic to non-target organisms. Therefore, the development of enantioselective analytical methodologies enabling their determination presents a high interest. Different separation techniques, including high performance liquid chromatography, gas chromatography, supercritical fluid chromatography, and capillary electrophoresis, have been employed to achieve the chiral analysis of pyrethroids and organophosphorus insecticides. This review presents the characteristics of the stereoselective analytical methodologies developed with this aim from 2010 to April 2019 and their applications to the analysis of real samples as well as for toxicity and biodegradation studies

Enantiomeric separation of prothioconazole and prothioconazole-desthio by capillary electrophoresis. Degradation studies in environmental simples

In this work, two analytical methodologies by Capillary Electrophoresis were developed. The first one enabled the rapid and cost-effective enantioseparation of prothioconazole and was applied to the analysis of prothioconazole-based commercial agrochemical formulations. The second methodology enabled the simultaneous enantioseparation of prothioconazole and its metabolite prothioconazole-desthio and was applied to degradation studies of both compounds in soil and sand samples. The influence of several experimental variables was investigated to develop both methodologies. The separation of prothioconazole enantiomers was achieved in 4.5 min with a resolution of 2.8 employing a neutral cyclodextrin (heptakis(2,3,6-tri-O-methyl)-?-cyclodextrin). Given the nature of prothioconazole-desthio, a neutral cyclodextrin cannot be used for its chiral separation. For this reason, the simultaneous enantioseparation of prothioconazole and prothioconazole-desthio was achieved in 5.5 min with resolution values of 1.9 and 8.2, respectively, using a negatively charged cyclodextrin (sulfated-?-cyclodextrin). The analytical characteristics of the developed methodologies were evaluated and both methods showed good performance to be applied to the quantitation of the enantiomers of prothioconazole in commercial agrochemical formulations (LOD 0.7 mg L-1) and to carry out degradation studies for both compounds in environmental matrices (LODs lower than 0.9 and 1.3 mg L-1 for prothioconazole and prothioconazole-desthio enantiomers, respectively). The recovery values obtained were in the range between 94-104 % for the agrochemical formulations, between 96-99 % for the sand samples and between 97-100 % for the soil samples

Hábitos deportivos de la población ecuatoriana en la ciudad de Madrid: análisis de su influencia en el proceso de integración en la sociedad española

This paper presents the results of a research work on the sporting habits of the immigrant population from Ecuador in the city of Madrid and the influence of their sport practice in their integration into Spanish society.The sample consisted of 288 ecuadorians (161 men and 127 women), aged between 17 and 64.The methodology was based on the Acculturation Model of Berry et al. (2006) and the Relative Acculturation Extended Model of Navas et al. (2004) The instrument for data collection was a questionnaire developed from the works of Navas et al. (2004), Berry (2002 & 2006), Taylor (2000), Nehas (2000), Reshef (1990) and García Ferrando (2001).The results of this research might be very usefull both for the sport policies aimed at promoting the integration of immigrants in host societies, and for the management and planning of programs and interventions related to sports and immigration.Este artículo presenta los resultados de una investigación sobre los hábitos deportivos de la población inmigrante ecuatoriana en la ciudad de Madrid y el grado de influencia que ejerce la práctica deportiva en su integración en la sociedad española.La muestra estuvo constituida por 288 personas ecuatorianas (161 varones y 127 mujeres) con una edad comprendida entre los 17 y 64 años.El diseño metodológico se basó en el Modelo de Aculturación de Berry y col. (2006) y el Modelo Ampliado de Aculturación Relativa (MAAR) de Navas y col. (2004) El instrumento para la recogida de datos fue el cuestionario, elaborado a partir de los trabajos de Navas y col., Berry (2002 y 2006), Taylor (2000), Nehas (2000), Reshef (1990) y García Ferrando (2001).Los resultados de esta investigación pueden ser de gran utilidad tanto en la adopción de políticas deportivas que favorezcan la integración de la población inmigrante en las sociedades de acogida, como en la gestión y planificación de programas deportivos orientados a la población inmigrante

Hábitos deportivos de la población ecuatoriana en la ciudad de Madrid: análisis de su influencia en el proceso de integración en la sociedad española

Este artículo presenta los resultados de una investigación sobre los hábitos deportivos de la población inmigrante ecuatoriana en la ciudad de Madrid y el grado de influencia que ejerce la práctica deportiva en su integración en la sociedad española.La muestra estuvo constituida por 288 personas ecuatorianas (161 varones y 127 mujeres) con una edad comprendida entre los 17 y 64 años.El diseño metodológico se basó en el Modelo de Aculturación de Berry y col. (2006) y el Modelo Ampliado de Aculturación Relativa (MAAR) de Navas y col. (2004) El instrumento para la recogida de datos fue el cuestionario, elaborado a partir de los trabajos de Navas y col., Berry (2002 y 2006), Taylor (2000), Nehas (2000), Reshef (1990) y García Ferrando (2001).Los resultados de esta investigación pueden ser de gran utilidad tanto en la adopción de políticas deportivas que favorezcan la integración de la población inmigrante en las sociedades de acogida, como en la gestión y planificación de programas deportivos orientados a la población inmigrante.This paper presents the results of a research work on the sporting habits of the immigrant population from Ecuador in the city of Madrid and the influence of their sport practice in their integration into Spanish society.The sample consisted of 288 ecuadorians (161 men and 127 women), aged between 17 and 64.The methodology was based on the Acculturation Model of Berry et al. (2006) and the Relative Acculturation Extended Model of Navas et al. (2004) The instrument for data collection was a questionnaire developed from the works of Navas et al. (2004), Berry (2002 & 2006), Taylor (2000), Nehas (2000), Reshef (1990) and García Ferrando (2001).The results of this research might be very usefull both for the sport policies aimed at promoting the integration of immigrants in host societies, and for the management and planning of programs and interventions related to sports and immigration

Stereoselective separation of sulfoxaflor by electrokinetic chromatography and applications to stability and ecotoxicological studies

An Electrokinetic Chromatography method was developed for the stereoselective analysis of sulfoxaflor, a novel sulfoximine agrochemical with two chiral centers. A screening with fourteen negatively charged CDs was performed and Succinyl-?-CD (Succ-?-CD) was selected. A 15 mM concentration of this CD in a 100 mM borate buffer (pH 9.0), using an applied voltage of 20 kV and a temperature of 15 ?C made possible the baseline separation of the four stereoisomers of sulfoxaflor in 13.8 min. The evaluation of the linearity, accuracy, precision, LODs and LOQs of the method developed showed its performance to be applied to the analysis of commercial agrochemical formulations, the evaluation of the stability of sulfoxaflor stereoisomers under biotic and abiotic conditions, and to predict, for the first time, sulfoxaflor toxicity (using real concentrations instead of nominal concentrations), on two non-target aquatic organisms, the freshwater plant, Spirodela polyrhiza, and the marine bacterium, Vibrio fischer

Enantiomeric separation of panthenol by Capillary Electrophoresis. Analysis of commercial formulations and toxicity evaluation on non-target organisms

The first CE methodology enabling the enantiomeric separation of panthenol was developed in this work. Electrokinetic chromatography with cyclodextrins (CD-EKC) was the CE mode employed for this purpose. The effect of different experimental variables such as the nature and concentration of the cyclodextrin, the temperature and the separation voltage was investigated. The best enantiomeric separation was obtained with 25 mM (2-carboxyethyl)-?-CD (CE-?-CD) in 100 mM borate buffer (pH 9.0), with a separation voltage of 30 kV and a temperature of 30?C. Under these conditions, an enantiomeric resolution of 2.0 in an analysis time of 4.2 min was obtained, being the biologically active enantiomer D-panthenol (dexpanthenol) the second-migrating enantiomer. The analytical characteristics of the method were evaluated in terms of precision, accuracy, selectivity, linearity, LOD, and LOQ, showing a good performance for the quantitation of dexpanthenol in cosmetic and pharmaceutical formulations. The enantiomeric impurity (L-panthenol) could be detected at a 0.1 % level with respect to the majority enantiomer, allowing to accomplish the requirements of the ICH guidelines. The method was also successfully applied to study the stability of panthenol under abiotic and biotic conditions and its toxicity on non-target organisms (the aquatic plant Spirodela polyrhiza)

Factores predisponentes para ictericia neonatal en los pacientes egresados de la UCI neonatal, Hospital Infantil los Ángeles de Pasto

Introduction: Neonatal jaundice is one of the most common conditions in newborns; however, improper treatment can be harmful to the patient, despite being benign. Objective: To determine the predisposing factors of neonatal jaundice in patients discharged from the neonatal ICU of Los Angeles children's Hospital in the city of Pasto (Nariño) between January 2007and August 2011. Materials and methods: An observational, descriptive, retrospective and quantitative study was conducted. 608 clinical histories of discharged infants diagnosed with neonatal jaundice were studied. The variables studied were analyzed with the complement of Excel, XLSTAT-Pro 7.5.2. Results: The main predisposing factors found in the population were exclusive breastfeeding and male gender in 87%, and 57.40% respectively; besides, 90.79% were newborns at term, 92.93% had adequate weight for their gestational age and 54.93% presented neonatal jaundice between 2 and 7 days of extrauterine life. Conclusions: Neonatal jaundice is associated with both modifiable and non-modifiable maternal and neonatal factors that can be addressed with appropriate strategies to reduce the burden of disease

Features Associated With Depressive Predominant Polarity and Early Illness Onset in Patients With Bipolar Disorder

Objective: The aim of this study is to determine the prevalence of three possible diagnostic specifiers, namely predominant polarity (PP) throughout illness, polarity of the first episode and early age at onset, in a sample of bipolar disorder (BD) patients and their association with important socio-demographic, clinical and course-of-illness variables. Methods: A retrospective and naturalistic study on 108 BD outpatients, who were classified according to the PP, polarity of the first episode and early age at onset ( 20 years) [vs. late (>20 years)] and were characterized by their demographics, clinical data, functionality and social support, among others features. After bivariate analyses, those variables showing certain association (P value < 0.25) with the three dependent variables were entered in logistic regression backward selection procedures to identify the variables independently associated with the PP, polarity of the first episode and early age at onset. Results: The sample consisted of 75 women ad 33 men, 74% with type I BD and 26% with type II. Around 70% had depressive PP, onset with a depressive episode and onset after age 20. Depressive PP was independently associated with depressive onset, higher score on the CGI severity scale and work disability. Onset with depressive episode was associated with type II BD, longer diagnostic delay and higher score on family disability. Early age at onset ( 20 years) was associate with younger age, longer diagnostic delay, presence of ever psychotic symptoms, current use of antipsychotic drugs and higher social support score. Conclusions: The results of this study show that BD patients with depressive PP, onset with depression and early age at onset may represent greater severity, because they are frequently associated with variables that worsen the prognosis. Our findings match up with the conclusions of two systematic reviews and we also include a disability factor (at family and work) that has not been previously reported. This work contributes to the use of polarity and age at onset in BD patients, as it can become a useful instrument in the prognostic and therapeutic applications