Conocimiento de la higiene de manos en estudiantes de enfermería

Nursing students’ hands can be the vector of nosocomial infection. Improving knowledge about hand hygiene (HM) reduces nosocomial infection. This is the reason we must know the degree of adherence to hand washing protocol (LM) by nursing studentsFor this purpose, a WHO structured questionnaire for health professionals was done before and after putting a training workshop into practice.A total of 63 students from two nursing degree courses of UEX have participated in the study, with female sector predominance 76.2% (48) and 23.8% (15) for the male. Very significant data were obtained (p <0.015) in the questionnaire P9a (0.012), P9B (0,000) P10 (0,000) P11 and (0.005), P11f (0.002).Students have a moderate knowledge about HM. The study shows the need to improve existing HM training programs, to address gaps in knowledge and to obtain highly qualified nurses in the futureLas manos de los estudiantes de enfermería pueden ser el vector de la infección nosocomial. La mejora en el conocimiento sobre la higiene de manos (HM) reduce la infección nosocomial. Para ello debemos conocer el grado de adherencia al protocolo de lavado de manos (LM) por parte de los alumnos de enfermeríaPara ello se pasó un cuestionario estructurado de la OMS para profesionales de salud, antes y después de llevar a cabo un taller formativo. Han participado en el Estudio un total de 63 alumnos de dos cursos de grado en enfermería de la Universidad de Extremadura (UEX), con una predominancia del sector femenino en 76,2 % (48) y 23,8 % (15) para el masculino.Se obtuvo datos muy significativos (p<0,015) en el cuestionario en P9a (0,012), P9b (0,000), P10 (0,000), P11 e (0,005), P11f  (0,002). Los estudiantes tienen un conocimiento moderado sobre HM. El estudio muestra la necesidad de seguir mejorando los programas de formación de HM existentes, para hacer frente a las lagunas en los conocimientos y obtener unos enfermeros altamente cualificados en el futuro

Emulación del sistema músculo-esqueletal y el control de movimiento en una plataforma experimental

Muchos fisiólogos han observado que el músculo humano o animal es una especie de tejido elástico (como un muelle) con componentes contráctiles, los cuales dan una longitud de umbral modificable neuralmente para el desarrollo de fuerzas. La determinación de las fuerzas del músculo durante el movimiento no es solamente esencial para el análisis de las cargas internas que actúan en los huesos y articulaciones, si no que también contribuyen ha entender más profundamente los controladores neuronales. Los sistemas de control biológicos han sido estudiados como una posible inspiración para la construción de controladores de sistemas robóticos. En este trabajo, se diseño e implemento un sistema biomecánico que tiene propiedades mécanicas casi similares a las de un brazo humano o animal. En este sistema se implementaron modelos matemáticos del músculo biológico, para la generación de fuerzas en el músculo esqueletal total. Además, se desarrollo una red cortical para el control de movimientos voluntarios con restricciones neurofisiológicas y psicofísicas motoras. El controlador neuronal es propuesto para realizar el seguimiento de trajectorias deseadas en la articulación de un simple eslabón controlado por un par de actuadores agonista-antagonista con propiedades musculares. El sistema es capaz de ejecutar movimientos de alcance voluntarios, con perfiles de velocidad en forma de campana bajo perturbaciones. Los resultados experimentales muestran que el sistema presenta las propiedades básicas del músculoesqueletal las cuales son las relaciones fuerza-longitud y fuerza-velocidad. El controlador neuronal permite controlar los movimientos deseados y compesar las fuerzas externas.Se agradece el apoyo recibido por los miembros del grupo de investigación de Neurotecnología, Control y Robótica (NEUROCOR) del departamento de Ingeniería de Sistemas y Automática de la Universidad Politécnica de Cartagena. Este trabajo fue financiado en parte por la CICYTTIC99- 0446-C02-01, y por el proyecto SYNERAGH - BRE2-CT980797 BRITE EURAM- de Investigación Básica

Plantar pressures values related with appearance of mechanical hyperkeratosis before and after surgery of mild hallux valgus

BackgroundHyperkeratoses are thickenings of the stratum corneum, provoked by deviation of the ray and excessive plantar pressures. They are very common under the first metatarsal head (MTH) and on the big toe when there exists hallux valgus. The objective of this study was to assess plantar pressures pre- and post-surgery to try to define the threshold values that could determine the appearance of keratopathies.Materials and methodsSeventy-nine patients (100 feet) who had undergone percutaneous distal soft-tissue release and the Akin procedure were evaluated prospectively. The BioFoot/IBV® in-shoe system was used for objective baropodometric functional evaluations of the heel, midfoot, first through fifth MTHs, hallux, and lesser toes. The presence or absence of a hyperkeratosis (HK) or plantar callus under the first MTH or hallux was recorded. The average follow-up time at which the measurements were repeated was 28.1 months.ResultsPre-surgery, 62 feet presented a painful HK on the big toe, while post-surgery, only 9 of the feet presented the same lesion. Patients who presented a prior HK at the first metatarsophalangeal (MTP) joint had a mean pressure of 417.2 ± 254.5 kPa as against a value of 359.6 ± 185.1 kPa for the rest. Post-surgery, these values dropped to 409.8 and 346.3 kPa, respectively.ConclusionPatients with HK presented an 11% greater mean pressure than those without. The values obtained with the BioFoot/IBV® system in the present study can therefore be considered predictive of the appearance of HK under the first MTH and on the side of the big toe

Hand hygiene technique quality evaluation in nursing and medicine students of two academic courses

Objetivo:assim como as mãos dos professionais de saúde, as mãos dos estudantes de Enfermagem e Medicina durante os estágios clínicos podem funcionar como veículo de transmissão das infecções hospitalares.Método:estudo descritivo com estudantes de Graduação em Enfermagem e Medicina. Avaliou-se a qualidade da técnica de higiene das mãos por meio de prova visual a partir de solução hidro-alcoólica marcada com fluoresceína e lâmpada de luz ultravioleta.Resultados:avaliaram-se 546 alunos, 73,8% da Graduação em Medicina e 26,2% da Enfermagem. As áreas das mãos com correta distribuição de sabão foram as palmas (92,9%); as áreas não esfregadas corretamente foram os polegares (55,1%). Em ambas as mãos, a higienização foi muito boa em 24,7%, boa em 29,8%, regular em 25,1% e má em 20,3%. Os piores foram: os homens, os estudantes de Enfermagem e os estudantes do primeiro ano de escola. Não houve diferenças significativas por idade.Conclusões:a técnica de higiene de mãos não foi realizada de modo eficaz. O papel educativo é fundamental para sedimentar as bases de boas práticas na higienização das mãos, em conhecimentos teóricos e no desenvolvimento de habilidades e reforço de boas práticasObjective: because they are health professionals, nursing and medical students' hands during internships can function as a transmission vehicle for hospital-acquired infections.Method: a descriptive study with nursing and medical degree students on the quality of the hand hygiene technique, which was assessed via a visual test using a hydroalcoholic solution marked with fluorescence and an ultraviolet lamp.Results: 546 students were assessed, 73.8% from medicine and 26.2% from nursing. The area of the hand with a proper antiseptic distribution was the palm (92.9%); areas not properly scrubbed were the thumbs (55.1%). 24.7% was very good in both hands, 29.8% was good, 25.1% was fair, and 20.3% was poor. The worst assessed were the male, nursing and first year students. There were no significant differences in the age groups.Conclusions: hand hygiene technique is not applied efficiently. Education plays a key role in setting a good practice base in hand hygiene, theoretical knowledge, and in skill development, as well as good practice reinforcement.Objetivo:al igual que los profesionales sanitarios, las manos de los estudiantes de enfermería y medicina durante las estancias clínicas pueden funcionar como vehículo de trasmisión de las infecciones nosocomiales.Método:estudio descriptivo con estudiantes de Grado de Enfermería y de Medicina. Se evaluó la calidad de la técnica de la higiene de manos por prueba visual con solución hidroalcohólica marcada con fluoresceína y lámpara de luz ultravioleta.Resultados:se evaluó a 546 alumnos, Grado de Medicina 73,8% y 26,2% de Enfermería. Las zonas de las manos con una correcta distribución de desinfectante fueron las palmas (92,9%); las no frotadas correctamente fueron los pulgares (55,1%). En ambas manos fue muy buena en el 24,7%, buena en el 29,8%, regular en 25,1% y mala en 20,3%. Los peores han sido: los hombres, los estudiantes de enfermería y los de primer año de estudio. No hubo diferencias significativas por edad.Conclusiones:no se realizó la técnica de higiene de manos de una manera eficaz. El papel de la educación es fundamental para sentar las bases de buenas prácticas en higiene de manos, en conocimientos teóricos y en el desarrollo de habilidades y el refuerzo de buenas práctica

Evaluación de la calidad de la técnica de higiene de manos en alumnos de enfermería y medicina en dos cursos académicos

Objetivo: al igual que los profesionales sanitarios, las manos de los estudiantes de enfermería y medicina durante las estancias clínicas pueden funcionar como vehículo de trasmisión de las infecciones nosocomiales. Método: estudio descriptivo con estudiantes de Grado de Enfermería y de Medicina. Se evaluó la calidad de la técnica de la higiene de manos por prueba visual con solución hidroalcohólica marcada con fluoresceína y lámpara de luz ultravioleta. Resultados: se evaluó a 546 alumnos, Grado de Medicina 73,8% y 26,2% de Enfermería. Las zonas de las manos con una correcta distribución de desinfectante fueron las palmas (92,9%); las no frotadas correctamente fueron los pulgares (55,1%). En ambas manos fue muy buena en el 24,7%, buena en el 29,8%, regular en 25,1% y mala en 20,3%. Los peores han sido: los hombres, los estudiantes de enfermería y los de primer año de estudio. No hubo diferencias significativas por edad. Conclusiones: no se realizó la técnica de higiene de manos de una manera eficaz. El papel de la educación es fundamental para sentar las bases de buenas prácticas en higiene de manos, en conocimientos teóricos y en el desarrollo de habilidades y el refuerzo de buenas prácticasObjective: because they are health professionals, nursing and medical students’ hands during internships can function as a transmission vehicle for hospital-acquired infections. Method: a descriptive study with nursing and medical degree students on the quality of the hand hygiene technique, which was assessed via a visual test using a hydroalcoholic solution marked with fluorescence and an ultraviolet lamp. Results: 546 students were assessed, 73.8% from medicine and 26.2% from nursing. The area of the hand with a proper antiseptic distribution was the palm (92.9%); areas not properly scrubbed were the thumbs (55.1%). 24.7% was very good in both hands, 29.8% was good, 25.1% was fair, and 20.3% was poor. The worst assessed were the male, nursing and first year students. There were no significant differences in the age groups. Conclusions: hand hygiene technique is not applied efficiently. Education plays a key role in setting a good practice base in hand hygiene, theoretical knowledge, and in skill development, as well as good practice reinforcement.Objetivo: assim como as mãos dos professionais de saúde, as mãos dos estudantes de Enfermagem e Medicina durante os estágios clínicos podem funcionar como veículo de transmissão das infecções hospitalares. Método: estudo descritivo com estudantes de Graduação em Enfermagem e Medicina. Avaliou-se a qualidade da técnica de higiene das mãos por meio de prova visual a partir de solução hidro-alcoólica marcada com fluoresceína e lâmpada de luz ultravioleta. Resultados: avaliaram-se 546 alunos, 73,8% da Graduação em Medicina e 26,2% da Enfermagem. As áreas das mãos com correta distribuição de sabão foram as palmas (92,9%); as áreas não esfregadas corretamente foram os polegares (55,1%). Em ambas as mãos, a higienização foi muito boa em 24,7%, boa em 29,8%, regular em 25,1% e má em 20,3%. Os piores foram: os homens, os estudantes de Enfermagem e os estudantes do primeiro ano de escola. Não houve diferenças significativas por idade. Conclusões: a técnica de higiene de mãos não foi realizada de modo eficaz. O papel educativo é fundamental para sedimentar as bases de boas práticas na higienização das mãos, em conhecimentos teóricos e no desenvolvimento de habilidades e reforço de boas práticaspeerReviewe

Osimertinib in advanced EGFR-T790M mutation-positive non-small cell lung cancer patients treated within the Special Use Medication Program in Spain : OSIREX-Spanish Lung Cancer Group

AURA study reported 61% objective response rate and progression-free survival of 9.6 months with osimertinib in patients with EGFR/T790M+ non-small cell lung cancer. Due to lack of real-world data, we proposed this study to describe the experience with osimertinib in Spain. Post-authorization, non-interventional Special Use Medication Program, multicenter, retrospective study in advanced EGFR/T790M+ non-small cell lung cancer. One hundred-fifty five patients were enrolled (August 2016-December 2018) from 30 sites. Primary objective: progression-free survival. Secondary objectives: toxicity profile, objective response rate, and use of health service resources. 70% women, median age 66. 63.9% were non-smokers and 99% had adenocarcinoma. Most patients had received at least one prior treatment (97%), 91.7% had received previous EGFR-tyrosine kinase inhibitors and 2.8% osimertinib as first-line treatment. At data cutoff, median follow-up was 11.8 months. One hundred-fifty five patients were evaluable for response, 1.3% complete response, 40.6% partial response, 31% stable disease and 11.6% disease progression. Objective response rate was 42%. Median progression-free survival was 9.4 months. Of the 155 patients who received treatment, 76 (49%) did not reported any adverse event, 51% presented some adverse event, most of which were grade 1 or 2. The resource cost study indicates early use is warranted. This study to assess the real-world clinical impact of osimertinib showed high drug activity in pretreated advanced EGFR/T790M+ non-small cell lung cancer, with manageable adverse events. Clinical trial registration number : NCT03790397

Methionine Cycle Rewiring by Targeting miR-873-5p Modulates Ammonia Metabolism to Protect the Liver from Acetaminophen

Drug-induced liver injury (DILI) development is commonly associated with acetaminophen (APAP) overdose, where glutathione scavenging leads to mitochondrial dysfunction and hepatocyte death. DILI is a severe disorder without effective late-stage treatment, since N-acetyl cysteine must be administered 8 h after overdose to be efficient. Ammonia homeostasis is altered during liver diseases and, during DILI, it is accompanied by decreased glycine N-methyltransferase (GNMT) expression and S-adenosylmethionine (AdoMet) levels that suggest a reduced methionine cycle. Anti-miR-873-5p treatment prevents cell death in primary hepatocytes and the appearance of necrotic areas in liver from APAP-administered mice. In our study, we demonstrate a GNMT and methionine cycle activity restoration by the anti-miR-873-5p that reduces mitochondrial dysfunction and oxidative stress. The lack of hyperammoniemia caused by the therapy results in a decreased urea cycle, enhancing the synthesis of polyamines from ornithine and AdoMet and thus impacting the observed recovery of mitochondria and hepatocyte proliferation for regeneration. In summary, anti-miR-873-5p appears to be an effective therapy against APAP-induced liver injury, where the restoration of GNMT and the methionine cycle may prevent mitochondrial dysfunction while activating hepatocyte proliferative response.We thank Ministerio de Ciencia e Innovación, Programa Retos-Colaboración RTC2019- 007125-1 (for J.S. and M.L.M.-C.); Instituto de Salud Carlos III: Proyectos de Investigación en Salud DTS20/00138 (for J.S. and M.L.M.-C.), PI20/00690 (for R.J.) and PT20/000127 (for M.I.L.); CIBERehd: EHD21TRF01/2022 (to M.L.M.-C.); Departamento de Industria del Gobierno Vasco (for M.L.M.-C.); Ministerio de Ciencia, Innovación y Universidades MICINN: PID2020-117116RB-I00 and RTI2018- 096759-1-100 integrado en el Plan Estatal de Investigación Cientifica y Técnica y Innovación, cofinanciado con Fondos FEDER (for M.L.M.-C. and T.C.D., respectively); BIOEF (Basque Foundation for Innovation and Health Research); Asociación Española contra el Cáncer (AECC) (to M.L.M.-C., T.C.D.); AECC: GCTRA18006CARR (to A.C.); Fundación Científica de la Asociación Española Contra el Cancer (AECC Scientific Foundation) Rare Tumor Calls 2017 (for M.L.M.); La Caixa Foundation Program (for M.L.M.); BFU2015-70067-REDC, BFU2016-77408-R and BES-2017-080435 (MINECO/FEDER, UE); Ministerio de Ciencia, Innovación y universidades PID2019-108787RB-100 (to A.C.), PID2019- 109055RB-I00 (L.A.M.-C.), PID2020-117941RB-100 (to F.J.C.); Spanish Ministry of Economy and Competitiveness Grants BFU2013-47531-R and BFU2016-77408-R (L.A.M.-C.) and the FIGHT-CNNM2 project from the EJP RD Joint Transnational Call (JTC2019) (Ref. AC19/00073) (for L.A.M.-C.); Comunidad de Madrid: EXOHEP-CM S2017/BMD-3727 and NanoLiver-CM Y2018/NMT-4949 co-funded by European Structural and Investment Fund and COST Action CA17112 (to F.J.C.); Vencer el Cáncer Foundation (to A.C.); European Research Council: Consolidator Grant 819242 (to A.C.); CIBERONC and CIBERehd were funded by the Instituto de Salud Carlos III and Cofunded by FEDER funds. Partial funding for open access charge: Universidad de Málag

Neuroblastoma RAS viral oncogene homolog (N-RAS) deficiency aggravates liver injury and fibrosis.

Progressive hepatic damage and fibrosis are major features of chronic liver diseases of different etiology, yet the underlying molecular mechanisms remain to be fully defined. N-RAS, a member of the RAS family of small guanine nucleotide-binding proteins also encompassing the highly homologous H-RAS and K-RAS isoforms, was previously reported to modulate cell death and renal fibrosis; however, its role in liver damage and fibrogenesis remains unknown. Here, we approached this question by using N-RAS deficient (N-RAS-/-) mice and two experimental models of liver injury and fibrosis, namely carbon tetrachloride (CCl4) intoxication and bile duct ligation (BDL). In wild-type (N-RAS+/+) mice both hepatotoxic procedures augmented N-RAS expression in the liver. Compared to N-RAS+/+ counterparts, N-RAS-/- mice subjected to either CCl4 or BDL showed exacerbated liver injury and fibrosis, which was associated with enhanced hepatic stellate cell (HSC) activation and leukocyte infiltration in the damaged liver. At the molecular level, after CCl4 or BDL, N-RAS-/- livers exhibited augmented expression of necroptotic death markers along with JNK1/2 hyperactivation. In line with this, N-RAS ablation in a human hepatocytic cell line resulted in enhanced activation of JNK and necroptosis mediators in response to cell death stimuli. Of note, loss of hepatic N-RAS expression was characteristic of chronic liver disease patients with fibrosis. Collectively, our study unveils a novel role for N-RAS as a negative controller of the progression of liver injury and fibrogenesis, by critically downregulating signaling pathways leading to hepatocyte necroptosis. Furthermore, it suggests that N-RAS may be of potential clinical value as prognostic biomarker of progressive fibrotic liver damage, or as a novel therapeutic target for the treatment of chronic liver disease

Inter-Rater Variability in the Evaluation of Lung Ultrasound in Videos Acquired from COVID-19 Patients

12 páginas, 7 figuras, 1 tablaLung ultrasound (LUS) allows for the detection of a series of manifestations of COVID-19, such as B-lines and consolidations. The objective of this work was to study the inter-rater reliability (IRR) when detecting signs associated with COVID-19 in the LUS, as well as the performance of the test in a longitudinal or transverse orientation. Thirty-three physicians with advanced experience in LUS independently evaluated ultrasound videos previously acquired using the ULTRACOV system on 20 patients with confirmed COVID-19. For each patient, 24 videos of 3 s were acquired (using 12 positions with the probe in longitudinal and transverse orientations). The physicians had no information about the patients or other previous evaluations. The score assigned to each acquisition followed the convention applied in previous studies. A substantial IRR was found in the cases of normal LUS (κ = 0.74), with only a fair IRR for the presence of individual B-lines (κ = 0.36) and for confluent B-lines occupying 50% (κ = 0.50). No statistically significant differences between the longitudinal and transverse scans were found. The IRR for LUS of COVID-19 patients may benefit from more standardized clinical protocols.This research was partially funded by CDTI (Spanish acronym: Centre for Industrial Tech- nological Development), funding number COI-20201153. Partially supported by the Google Cloud Research Credits program with the funding number GCP19980904, by the project RTI2018-099118- A-I00 founded by MCIU/AEI/FEDER UE and by the European Commission–NextGenerationEU, through CSIC’s Global Health Platform (PTI Salud Global)

Objetivos de desarrollo sostenible y Derechos Humanos: paz, justicia e instituciones sólidas / Derechos Humanos y empresas

Nota previa / Cástor Miguel Díaz Barrado (pp. 7-9). -- Unión Europea: Derechos Humanos y desarrollo sostenible / Araceli Mangas Martín (pp. 13 - 26). -- Paz, seguridad y gobernanza: el ODS 16 y la Agenda 2030 de desarrollo sostenible / José Antonio Sanahuja (pp. 27 - 54). -- La aplicación extraterritorial de los Derechos Humanos por acciones de empresas / Pablo Antonio Fernández Sánchez (pp. 57 - 60). -- Hacia un futuro tratado internacional sobre las empresas y los Derechos Humanos / Eugenia López-Jacoiste (pp. 61 - 73). -- La importancia del enfoque de los Derechos Humanos en los objetivos de desarrollo del sostenible / Diana M. Verdiales López (pp. 75 - 90). -- La perspectiva de género en la resolución de conflictos armados: las mujeres como agentes de paz / Cristina del Prado Higuera (pp. 93 - 106). -- La mutilación genital femenina desde una perspectiva integral y multidisciplinar / Cristina Hermida del Llano (pp. 107 - 120). -- Poner fin al maltrato, la explotación, la trata y todas las formas de violencia y tortura contra los niños: la trata de niños / María Ángeles Cano Linares (pp. 123 - 136). -- Participación juvenil en el fortalecimiento de las instituciones y el establecimiento de la paz: programas de participación juvenil del sistema de Naciones Unidas / Enrique Hernández Díez (pp. 137 - 160). -- Estado de la violencia criminal en la sociedad internacional: respuestas de la comunidad internacional para avanzar hacia el objetivo 16, Agenda 2030 / Sagrario Morán Blanco (pp. 163 - 178). -- Fortalecer la recuperación y devolución de bienes robados: justicia y reparación del daño causado a las víctimas y la sociedad como metas del objetivo 16 de los objetivos de desarrollo sostenible / Francisco Jiménez García (pp. 179 - 192). -- El derecho internacional, los ODS y la lucha contra el crimen transnacional / Juan Manuel Rodríguez Barrigón (pp. 193 - 216). -- El derecho internacional frente a la criminalidad financiera transnacional: la prevención y sanción del blanqueo de capitales / Jorge Urbaneja Cillán (pp. 217 - 232). -- Acceso a la justicia y objetivos del desarrollo sostenible / Florabel Quispe Remón (pp. 235 - 248). -- Paz y objetivos de desarrollo sostenible: la contribución del objetivo 16 / Elena C. Díaz Galán (pp. 249 - 262). -- Seguridad sanitaria y empresas / Ana Cristina Gallego Hernández (pp. 265 - 272). -- El acaparamiento de tierras por empresas multinacionales y la seguridad alimentaria / Adriana Fillol Mazo (pp. 273 - 288). -- Importancia y características de los planes nacionales de empresas y Derechos Humanos en relación con el desarrollo sostenible / Alberto Jiménez-Piernas García (pp. 289 - 301). -- Objetivo de desarrollo sostenible 16. Principios rectores y espacio iberoamericano: el caso Berta Cáceres / Ana Manero Salvador (pp. 305 - 315). -- Derechos de los pueblos indígenas: marcos de protección en la Agenda 2030 y en los principios rectores sobre empresas y Derechos Humanos / Juan Daniel Oliva Martínez y Adriana Sánchez Lizama (pp. 317 - 331