Quality of Life and Autonomy in Patients with Intermittent Bladder Catheterization Trained by Specialized Nurses

Intermittent bladder catheterization (IBC) involves regular urine draining using a catheter, which is removed immediately after urinary elimination. It allows for the patient's urological health to be managed and their renal function to be preserved, and it promotes autonomy. Compliance with the prescribed number of daily catheterizations, which must be conducted by the patient, and infection prevention measures are crucial. To identify the patients requiring IBC, and to determine their adherence (whether they followed the prescribed guidelines and their difficulty in carrying out the procedure, as well as to assess how the IBC influences their quality of life and state of mind after receiving self-care training from a specialized nurse), we carried out a prospective, multicenter observational study in 24 Spanish hospitals with one month of monitoring and a sample of 99 patients. The sources of information were the patients' clinical records, the King's Health Questionnaire, the Mini-Mental State Examination (MMSE), and the hospital anxiety and depression scale (HADS). Descriptive and bivariate statistics were used to analyses the paired data. After recruitment (n = 99), 79 patients completed the questionnaire at a mean age of 35.2 years (SD = 20.5 years). In total, 53.5% (53) of the sample consisted of men and 32.3% (32) had neurological damage as the reason for prescription; 67% (67.7) performed self-catheterization and 86.7% adhered to the IBC. After one month of monitoring, a statistically significant improvement in quality of life was observed in all criteria, with the exception of personal relationships (p < 0.005), as well as an improvement in anxiety and depression levels (p < 0.001). Patients who require IBC show good adherence to the IBC with a significant percentage of self-catheterization. After one month of IBC, a significant improvement in the patients' quality of life and mood was observed. These results could be attributed to adequate patient training and adequate personalization of the IBC materials by the specialized nurses

EducaFarma 9.0

Memoria ID-020 Ayudas de la Universidad de Salamanca para la innovación docente, curso 2020-2021

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Educafarma 10.0

Memoria ID-030. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2021-2022

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

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

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p &lt; 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

Cultura de los pueblos de nuestra comarca

Se intenta, mediante el acercamiento a los valores, actitudes y tradiciones del entorno del C.E.A.S de Torres de la Alameda, facilitar el aprendizaje de las personas adultas. La metodología parte del proyecto curricular de Lenguaje y en él se desarrollan actividades como la recogida y selección de información, la realización de entrevistas para el conocimiento de la cultura popular, y la preparación de lecturas, juegos, exposiciones y encuentros comarcales. La valoración es positiva por la implicación generalizada de todo el personal que participa en el proyecto. Se ha propuesto dado el éxito de la experiencia publicar y difundir los resultados..Madrid (Comunidad Autónoma). Consejería de Educación y CulturaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Proteinas matricelulares y ateroesclerosis coronaria: relación de sus niveles plasmáticos con la presencia de calcio coronario demostrado por TC

Trabajo presentado en SEC Sevilla, celebrado en Sevilla (España) del 25 al 27 de octubre de 2018.[Introducción]: La matriz extracelular (MEC) es una asociación de distintos tipos de macromoléculas, que contribuyen a la formación, progresión y calcificación de la placa aterosclerótica. En los últimos años, los niveles séricos de varias proteínas vinculadas al remodelado de la MEC han demostrado tener valor pronóstico. Entre los componentes de la MEC, las proteínas matricelulares BMP-1, periostina y lisil oxidasa desempeña un papel crucial en el mantenimiento de su estabilidad y diferentes estudios han sugerido su implicación clínica en procesos de fibro-calcificación. Sin embargo, su papel como biomarcadores pronóstico en el contexto de la ateroesclerosis coronaria es menos conocido. En este ámbito, actualmente se dispone de técnicas de imagen mediante TC que permite demostrar ateroesclerosis coronaria en estadios preclínicos, expresada por la presencia de calcio (Score de Agatston).[Hipótesis y objetivos]: Determinar los niveles de BMP-1, periostina y lisil oxidasa en pacientes sin historia previa de cardiopatia isquemica sometidos a TC coronario y relacionarlos con la presencia de ateroesclerosis coronaria (calcio coronario).[Métodos]: Se han incluido 120 pacientes: 70 con evidencia de ateroesclerosis coronaria determinada por la presencia de calcio coronario en TC (CAC+) y 50 pacientes sin calcio (CAC-). Se analizaron datos antropométricos (IMC, perímetro abdominal) y valores de perfil lipídico (LDL, HDL, Lpa, Apo A1, ApoB). Los niveles plasmáticos de las proteínas matricelulares seleccionadas se cuantificaron mediante ELISA.[Resultados]: Entre los pacientes CAC+ (Score de Agatson 712±1197) y CAC- hubo diferencias en la edad media (63±10 vs 56±11; p=0,002) con similar género (varones 54% vs 46%, p=0,45). Los pacientes CAC+ presentaron niveles plasmáticos más altos de periostina, BMP-1 y LOX en comparación a los pacientes CAC- (15.18±4.10 vs 2.94±1.30 µg/ml, 12.58±2.24 vs 3.03±0.85 ng/ml, and 46.02±6.03 vs 11.71±4.00 ng/ml, respectivamente). En análisis univariados, los niveles más altos de todos los biomarcadores se asociaron con la presencia de CAC (p¿0,0001). En el análisis multivariante periostina, BMP-1 y LOX permanecieron significativos después del ajuste para los factores de riesgo cardiovascular tradicionales (p¿0,0001).[Conclusiones]: Los niveles de BMP-1, periostina y lisil oxidasa se encuentran elevados en pacientes asintomáticos con presencia de calcio coronario como expresión de ateroesclerosis coronaria, demostrada por TC

Supplementation with grape pomace in healthy women: Changes in biochemical parameters, gut microbiota and related metabolic biomarkers

This paper reports a comprehensive pilot study of the effects of dietary supplementation with grape pomace (GP) in humans. After an initial washout period, the diet of 10 healthy women was supplemented with a dairy amount of 1.4 g of a red Grape Pomace (GP) extract (Eminol®) for 21 days. Among the different biochemical and immune parameters measured in plasma, a significant decrease (p < 0.05) was observed in blood fasting glucose levels after the 21-day supplementation. Overall, the GP supplementation did not lead to significant changes in faecal bacterial populations or, in general, in the content of faecal and urine phenolic metabolites. Nevertheless, significant changes (p < 0.05) were observed in the short-chain and medium-chain fatty acid profiles (SCFAs and MCFAs). Due to observed inter-individual differences it was not possible to establish a pattern on the microRNA expression profile associated to GP supplementation, however modulation of the expression of miRNA related to glucose metabolism was perceived after the intervention period.This work was funded by the Spanish MINECO (Projects INNPACTO IPT 2012-0130-060000 and AGL2015-64522-C2-R) and Comunidad de Madrid (ALIBIRD-CM S2013/ABI-2728)Peer reviewe