Medicalización de la vida en la consulta: ¿hacia dónde caminamos?

ResumenEl poder de la medicina ha hecho atractiva la idea de «medicalizar» aspectos de la vida que se pueden percibir como problemas médicos aun sin serlo. La medicina, como reflejo de la cultura del bienestar, genera en ocasiones falsas necesidades, y aspectos de la vida cotidiana son medicalizados con el pretexto de tratar falsas enfermedades como astenia primaveral y timidez, o procesos biológicos naturales como la menopausia.A pesar del mayor bienestar material, cada día atendemos a más personas que se quejan de malestares que quizá tengan más que ver con «estar mal» que con auténticas «enfermedades». La lista puede ser interminable: tristeza, niños hiperactivos, vigorexias o adolescentes problemáticos, entre otros. En este artículo se revisan algunas intervenciones que desde la consulta contribuyen a fomentar dichas situaciones. La adversidad cotidiana adquiere hoy rango de enfermedad, de ahí el notable aumento de las consultas en los diferentes dispositivos sanitarios.AbstractThe power of medicine has lately enhanced the idea of medicalizing any aspects of life that can be perceived as medical problems. Medicine sometimes creates false needs and there is nowadays an increasing number of situations are medicalized with the pretext of treating fake diseases such as spring fatigue, shyness o natural biological processes like menopause.Despite the better life conditions, we now attend more people that complain about discomfort that may have more to do with «feeling sick» than with authentic disease. There is an endless list: sadness, hyperactive children, anorexia, bulimia, vigorexia or problematic teenagers, amongst others. In this article we revise some interventions that, contribute to promote these situations also from the own doctor's office. Everyday adversity acquires today the status of disease, hence the remarkable increase in these consultations in the diverse sanitary services

Annual report on Sunspot Counting Program 2016

Este programa observación nació a finales del año 2012 en la Universidad de Extremadura con el fin de ampliar aún más nuestra investigación en la reconstrucción de la actividad solar. Desde el 1 de Enero de 2013, nuestros recuentos de manchas solares se han presentado al Real Observatorio de Bélgica (ROB) como contribución a los esfuerzos internacionales de mantener y actualizar el número internacional de Manchas Solares. Para ello, hemos utilizado un pequeño refractor apocromático de 80 mm de diámetro de objetivo y 550 mm de longitud focal, a fin de proyectar una imagen de 150 mm de diámetro en una plantilla. Este informe proporciona un conjunto completo de los datos obtenidos durante el año 2016, con cuatro tablas que muestran nuestros datos. Por otra parte, el índice de referencia de las manchas solares se compara con nuestros resultados. Esperamos que esta publicación sea de utilidad a la comunidad científica que estudia el número de manchas solares: la mayor serie de índices solares derivadas de la observación directa del Sol.This program was born in late 2012 at the University of Extremadura (Badajoz, 38°53′ N 6°58′ W) in order to further extend our research in the reconstruction of past solar activity (see, for example, Vaquero, 2007). Since 1st January 2013, our sunspot counts have been submitted to the Royal Observatory of Belgium (ROB) as a contribution to the international effort of maintaining and updating the International Sunspot Number. For this purpose, we use a small apochromatic refractor –80 mm of objective diameter and 550 mm of focal length– to project a 150 mm diameter image onto a template. Then, a drawing is done so we obtain our sunspot counts from it. In this report, we provide a complete set of data obtained throughout the year 2016, with four Tables showing our data. Moreover, the reference sunspot index is compared with our results. We hope that this publication is useful to the scientific community studying the sunspot number: the longest solar index series derived from direct observation of the Sun

Annual report on Sunspot Counting Program 2019

Este programa nació a finales de 2012 en la Universidad de Extremadura (Badajoz, 38 ° 53 ′ N 6 ° 58 ′ O) para ampliar aún más nuestra investigación en la reconstrucción de la actividad solar pasada (ver, por ejemplo, Vaquero, 2007) . Desde el 1 de enero de 2013, nuestros recuentos de manchas solares se han enviado al Observatorio Real de Bélgica (ROB) como una contribución al esfuerzo internacional de mantener y actualizar el número internacional de manchas solares. Para este propósito, usamos un pequeño refractor apocromático –80 mm de diámetro objetivo y 550 mm de distancia focal– para proyectar una imagen de 150 mm de diámetro en una plantilla. Luego, se realiza un dibujo para que podamos obtener nuestros recuentos de manchas solares. Además, las observaciones solares de estaciones secundarias se llevan a cabo algunos días cuando falla la estación principal (en Badajoz). Una de estas estaciones también está en Badajoz (en una parte diferente de la ciudad) y está equipada con un refractor –90 mm de diámetro objetivo y 910 mm de distancia focal–, y la otra está en Valencia de las Torres (38 ° 24 ′ N 6 ° 00 ′ W) y está equipado con un refractor más pequeño –70 mm de diámetro objetivo y 700 mm de distancia focal–. En este informe, proporcionamos un conjunto completo de datos obtenidos a lo largo del año 2019, con cuatro tablas que incluyen nuestros datos. Además, el índice de referencia del número de manchas solares se compara con nuestros resultados. Esperamos que esta publicación sea útil para la comunidad científica que estudia el número de manchas solares: la serie de índice solar más larga derivada de la observación directa del Sol.This program was born in late 2012 at the University of Extremadura (Badajoz, 38°53′ N 6°58′ W) in order to further extend our research in the reconstruction of past solar activity (see, for example, Vaquero, 2007). Since 1st January 2013, our sunspot counts have been submitted to the Royal Observatory of Belgium (ROB) as a contribution to the international effort of maintaining and updating the International Sunspot Number. For this purpose, we use a small apochromatic refractor –80 mm of objective diameter and 550 mm of focal length– to project a 150 mm diameter image onto a template. Then, a drawing is done so we obtain our sunspot counts from it. Moreover, solar observations from secondary stations are carried out some days when the main station (in Badajoz) fails. One of these stations is in Badajoz too (in a different part of the city) and is equipped with a refractor –90 mm of objective diameter and 910 mm of focal length–, and the other one is in Valencia de las Torres (38°24′ N 6°00′ W) and is equipped with a smaller refractor –70 mm of objective diameter and 700 mm of focal length–. In this report, we provide a complete set of data obtained throughout the year 2019, with four tables including our data. Moreover, the reference sunspot number index is compared with our results. We hope that this publication is useful to the scientific community studying the sunspot number: the longest solar index series derived from direct observation of the Sun.• Fondos FEDER-Junta de Extremadura: Ayuda al Grupo de Investigación GR18097 y Proyecto IB16127 • Ministerio de Economía y Competitividad of the Spanish Government proyecto CGL2017-87917-P • Agencia Estatal de Investigación (Ministerio de Ciencia, Innovación y Universidades) del Gobierno español: beca predoctoral PRE2018-08489

Plant and animal endemism in the eastern Andean slope: challenges to conservation

Andean slope: challenges to conservatio

Diagnostic Performance Assessment of Saliva RT-PCR and Nasopharyngeal Antigen for the Detection of SARS-CoV-2 in Peru

Widely available and reliable testing for SARS-CoV-2 is essential for the public health response to the COVID-19 pandemic. We estimated the diagnostic performance of reverse transcription PCR (RT-PCR) performed on saliva and the SD Biosensor STANDARD Q antigen test performed on nasopharyngeal swab compared to the reference standard, nasopharyngeal swab (NP) RT-PCR. We enrolled participants living and/or seeking care in health facilities in North Lima, Peru from November 2020 to January 2021. Consenting participants underwent same-day RT-PCR on both saliva and nasopharyngeal swab specimens, antigen testing on a nasopharyngeal swab specimen, pulse oximetry, and standardized symptom assessment. We calculated sensitivity, specificity, and predictive values for the nasopharyngeal antigen and saliva RT-PCR compared to nasopharyngeal RT-PCR. Of 896 participants analyzed, 567 (63.3%) had acute signs/symptoms of COVID-19. The overall sensitivity and specificity of saliva RT-PCR were 85.8% and 98.1%, respectively. Among participants with and without acute signs/symptoms of COVID-19, saliva sensitivity was 87.3% and 37.5%, respectively. Saliva sensitivity was 97.4% and 56.0% among participants with cycle threshold (CT) values of #30 and .30 on nasopharyngeal RT-PCR, respectively. The overall sensitivity and specificity of nasopharyngeal antigen were 73.2% and 99.4%, respectively. The sensitivity of the nasopharyngeal antigen test was 75.1% and 12.5% among participants with and without acute signs/symptoms of COVID-19, and 91.2% and 26.7% among participants with CT values of #30 and .30 on nasopharyngeal RT-PCR, respectively. Saliva RT-PCR achieved the WHO-recommended threshold of .80% for sensitivity for the detection of SARS-CoV-2, while the SD Biosensor nasopharyngeal antigen test did not. IMPORTANCE In this diagnostic validation study of 896 participants in Peru, saliva reverse transcription PCR (RT-PCR) had .80% sensitivity for the detection of SARS-CoV-2 among all-comers and symptomatic individuals, while the SD Biosensor STANDARD Q antigen test performed on nasopharyngeal swab had,80% sensitivity, except for participants whose same-day nasopharyngeal RT-PCR results showed cycle threshold values of,30, consistent with a high viral load in the nasopharynx. The specificity was high for both tests. Our results demonstrate that saliva sampling could serve as an alternative noninvasive technique for RT-PCR diagnosis of SARS-CoV-2. The role of nasopharyngeal antigen testing is more limited; when community transmission is low, it may be used for mass screenings among asymptomatic individuals with high testing frequency. Among symptomatic individuals, the nasopharyngeal antigen test may be relied upon for 4 to 8 days after symptom onset, or in those likely to have high viral load, whereupon it showed .80% sensitivity.Revisión por pare

Health professions and risk of sporadic Creutzfeldt- Jakob disease, 1965 to 2010

In 2009, a pathologist with sporadic Creutzfeldt- Jakob Disease (sCJD) was reported to the Spanish registry. This case prompted a request for information on health-related occupation in sCJD cases from countries participating in the European Creutzfeldt Jakob Disease Surveillance network (EuroCJD). Responses from registries in 21 countries revealed that of 8,321 registered cases, 65 physicians or dentists, two of whom were pathologists, and another 137 healthcare workers had been identified with sCJD. Five countries reported 15 physicians and 68 other health professionals among 2,968 controls or non-cases, suggesting no relative excess of sCJD among healthcare professionals. A literature review revealed: (i) 12 case or small case-series reports of 66 health professionals with sCJD, and (ii) five analytical studies on health-related occupation and sCJD, where statistically significant findings were solely observed for persons working at physicians' offices (odds ratio: 4.6 (95 CI: 1.2-17.6)). We conclude that a wide spectrum of medical specialities and health professions are represented in sCJD cases and that the data analysed do not support any overall increased occupational risk for health professionals. Nevertheless, there may be a specific risk in some professions associated with direct contact with high human-infectivity tissue

Acceptability and feasibility of a virtual community of practice to primary care professionals regarding patient empowerment: A qualitative pilot study

Background: Virtual communities of practice (vCoPs) facilitate online learning via the exchange of experiences and knowledge between interested participants. Compared to other communities, vCoPs need to overcome technological structures and specific barriers. Our objective was to pilot the acceptability and feasibility of a vCoP aimed at improving the attitudes of primary care professionals to the empowerment of patients with chronic conditions. Methods: We used a qualitative approach based on 2 focus groups: one composed of 6 general practitioners and the other of 6 practice nurses. Discussion guidelines on the topics to be investigated were provided to the moderator. Sessions were audio-recorded and transcribed verbatim. Thematic analysis was performed using the ATLAS-ti software. Results: The available operating systems and browsers and the lack of suitable spaces and time were reported as the main difficulties with the vCoP. The vCoP was perceived to be a flexible learning mode that provided up-to-date resources applicable to routine practice and offered a space for the exchange of experiences and approaches. Conclusions: The results from this pilot study show that the vCoP was considered useful for learning how to empower patients. However, while vCoPs have the potential to facilitate learning and as shown create professional awareness regarding patient empowerment, attention needs to be paid to technological and access issues and the time demands on professionals. We collected relevant inputs to improve the features, content and educational methods to be included in further vCoP implementation. Trial registration: ClinicalTrials.gov, NCT02757781. Registered on 25 April 2016.This study was financed by Instituto de Salud Carlos III and Cofinanced by Fondo Europeo de Desarrollo Regional (FEDER). Ministerio de Economía y Competitividad. Gobierno de España. (PI15/00164, PI15/00586, PI15/00566

Exosomes derived from mesenchymal stem cells enhance radiotherapy-induced cell death in tumor and metastatic tumor foci

We have recently shown that radiotherapy may not only be a successful local and regional treatment but, when combined with MSCs, may also be a novel systemic cancer therapy. This study aimed to investigate the role of exosomes derived from irradiated MSCs in the delay of tumor growth and metastasis after treatment with MSC + radiotherapy (RT). The tumor cell loss rates found after treatment with the combination of MSC and RT and for exclusive RT, were: 44.4% % and 12,1%, respectively. Concomitant and adjuvant use of RT and MSC, increased the mice surviving time 22,5% in this group, with regard to the group of mice treated with exclusive RT and in a 45,3% respect control group. Moreover, the number of metastatic foci found in the internal organs of the mice treated with MSC + RT was 60% less than the mice group treated with RT alone. We reasoned that the exosome secreted by the MSC, could be implicated in tumor growth delay and metastasis control after treatment. Our results show that exosomes derived form MSCs, combined with radiotherapy, are determinant in the enhancement of radiation effects observed in the control of metastatic spread of melanoma cells and suggest that exosome-derived factors could be involved in the bystander, and abscopal effects found after treatment of the tumors with RT plus MSC. Radiotherapy itself may not be systemic, although it might contribute to a systemic effect when used in combination with mesenchymal stem cells owing the ability of irradiated MSCs-derived exosomes to increase the control of tumor growth and metastasis.This work was supported by CNPq, Conselho Nacional de Desenvolvimento Científico e Tecnológico – Brasil, Junta de Andalucía, project of Excellence from Junta de Andalucía P12-CTS-383 to FJO, Spanish Ministry of Economy and Competitiveness SAF2015-70520-R to FJO and JMRdA, RTICC RD12/0036/0026 and CIBER Cáncer ISCIII CB16/12/00421 to FJO

Adynaton 5

Revista de narrativa y poesía escrita en los talleres literarios de CETYS Universidad."Adynaton" es una revista del Círculo de Letras de CETYS Universidad