Evolución de la incidencia de la cetoacidosis en la Diabetes mellitus tipo 1 en niños menores de la Comunidad Autónoma de Extremadura (2008-2012)

La incidencia anual de cetoacidosis en el mundo desarrollado y en nuestro país es de alrededor de 4 a 8 episodios por cada 1000 pacientes por año, y la mortalidad llega hasta el 10%, siendo la primera causa de mortalidad infantil en niños con Diabetes mellitus tipo. Alrededor de 65000 niños menores de 15 años desarrollan anualmente Diabetes mellitus tipo 1 y, de ellos, el 80% presentan cetoacidosis diabética. El conocimiento de estas variaciones es útil para la prevención de la cetoacidosis diabética es prioritaria. Incidencia de los casos observados de Diabetes mellitus tipo 1 por provincias, género y tiempo. Durante el periodo 2008-2012, se registraron 192 en Extremadura, con una incidencia media de la diabetes de 23,98 por 100.000 habitantes/ año. Por sexo fue del 27,96 en los niños y en niñas de 19,78 Se detectó 78 casos de cetoacidosis con una incidencia media estándar de 9,73 % por 100000 habitantes año en Extremadura. Por sexo fue del 12,12 en los niños y en niñas de 7,19. En la provincia de Badajoz fue del 7,63 y en Cáceres del 13,73. Por lo tanto en Extremadura y sus provincias la tasa de incidencia de cetoacidosis diabética durante el periodo 2008-2012 es de la más alta de España. Con un incremento en la provincia de Badajoz y en la provincia de Cáceres semejante al incremento de los países de nuestro entorno.The annual incidence of ketoacidosis in the developed world and in our country is about 4 to 8 episodes per 1000 patients per year, and the mortality reaches 10%, being the first cause of mortality in children with type 2 diabetes mellitus. Around 65000 children under the age of 15 years annually develop diabetes mellitus type 1, of which 80% have diabetic ketoacidosis. The knowledge of these variations is useful for the prevention of diabetic ketoacidosis is a priority. Incidence of observed cases of Diabetes mellitus type 1 by provinces, gender and time. During the period 2008-2012, 192 were recorded in Extremadura, with an average incidence of diabetes of 23.98 per 100,000 inhabitants/ year. By sex was 27.96 in children and girls of 19.78 was detected 78 cases of ketoacidosis with an average standard of 9.73 % by 100000 inhabitants year in Extremadura. By sex was 12.12 in children and girls of 7.19. In the province of Badajoz was 7.63 and in Cáceres of 13.73. Therefore in Extremadura and its provinces the incidence rate of ketoacidosis during the period 2008-2012 is the highest in Spain. With an increase in the province of Badajoz and in the province of Cáceres, similar to the increase in the countries of our environment

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

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

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Knowledge of hand hygiene in nursing students

Las 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 enfermería Para 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.ABSTRACT 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 students For 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 futur

Thermal Response in Two Models of Socks with Different 3-D Weave Separations

Socks with the same three-dimensional plantar design but with different compositions in the separation of their weaves could have different thermoregulatory effects. The objective of this study was therefore to evaluate the temperatures on the sole of the foot after a 10-km run using two models of socks with different weave separations. In a sample of 20 individuals (14 men and 6 women), plantar temperatures were analyzed using a Flir E60bx® (Flir Systems) thermographic camera before and after a run of 10 km wearing two models of socks that had different separations between the fabric weaves (5 mm versus 3 mm). After the post-exercise thermographic analysis, the participants responded to a Likert-type survey to evaluate the physiological characteristics of the two models of socks. There was a significant increase of temperature (+4 °C, p p = 0.014). No significant differences were found in the scores on the physiological characteristics comfort survey (p > 0.05 in all cases). The two models presented similar thermoregulatory effects on the soles of the feet, although the model with the narrowest weave separation generated greater temperatures (+0.4 °C) under the first metatarsal head