Efficacy and safety of preoperative preparation with Lugol''s iodine solution in euthyroid patients with Graves’ disease (LIGRADIS Trial): Study protocol for a multicenter randomized trial

Background: Currently, both the American Thyroid Association and the European Thyroid Association recommend preoperative preparation with Lugol''s Solution (LS) for patients undergoing thyroidectomy for Graves’ Disease (GD), but their recommendations are based on low-quality evidence. The LIGRADIS trial aims to provide evidence either to support or refute the systematic use of LS in euthyroid patients undergoing thyroidectomy for GD. Methods: A multicenter randomized controlled trial will be performed. Patients =18 years of age, diagnosed with GD, treated with antithyroid drugs, euthyroid and proposed for total thyroidectomy will be eligible for inclusion. Exclusion criteria will be prior thyroid or parathyroid surgery, hyperparathyroidism that requires associated parathyroidectomy, thyroid cancer that requires adding a lymph node dissection, iodine allergy, consumption of lithium or amiodarone, medically unfit patients (ASA-IV), breastfeeding women, preoperative vocal cord palsy and planned endoscopic, video-assisted or remote access surgery. Between January 2020 and January 2022, 270 patients will be randomized for either receiving or not preoperative preparation with LS. Researchers will be blinded to treatment assignment. The primary outcome will be the rate of postoperative complications: hypoparathyroidism, recurrent laryngeal nerve injury, hematoma, surgical site infection or death. Secondary outcomes will be intraoperative events (Thyroidectomy Difficulty Scale score, blood loss, recurrent laryngeal nerve neuromonitoring signal loss), operative time, postoperative length of stay, hospital readmissions, permanent complications and adverse events associated to LS. Conclusions: There is no conclusive evidence supporting the benefits of preoperative treatment with LS in this setting. This trial aims to provide new insights into future Clinical Practice Guidelines recommendations. Trial registration: ClinicalTrials.gov identifier: NCT03980132. © 202

Analysis of the Situation of School-Based Physiotherapy Services in Spain

[Resumen] Antecedentes y objetivo. El alumnado con necesidades educativas especiales puede necesitar el apoyo específico y especializado de fisioterapia, con el fin de facilitar el desarrollo de su máximo potencial y ayudar en su inclusión educativa. La información acerca de la implementación de la fisioterapia en los centros educativos en el territorio español es muy escasa. El objetivo de este estudio es describir la situación de la fisioterapia en los centros educativos y compararla entre las diferentes comunidades autónomas. Materiales y métodos. Se realizó un estudio descriptivo y transversal a través de la elaboración de una encuesta online, diseñada junto a un panel de expertos a través del método Delphi. Se incluyeron seis bloques temáticos relacionados con la atención de fisioterapia, las condiciones laborales de los fisioterapeutas en los centros educativos y con la cobertura de las necesidades del alumnado. Resultados. Se obtuvieron 178 respuestas. Su distribución geográfica fue homogénea, aunque se detectaron grandes diferencias entre las comunidades autónomas. La mayoría de las personas encuestadas trabajan en centros de educación especial y existen comunidades autónomas en las que no se trabaja en centros ordinarios. Solo el 28,4% contestaron que la figura del fisioterapeuta está integrada en los equipos de orientación educativa de su comunidad autónoma y tienen la función de determinar la necesidad del recurso. Conclusiones. El desarrollo del trabajo de fisioterapia en los centros educativos como apoyo al alumnado con necesidades educativas especiales es desigual entre las comunidades autónomas, y en algunas, se considera insuficiente.[Abstract] Background and objective. Students with special educational needs may need the specific and specialized support of Physiotherapy in order to facilitate the development of their maximum potential and help in their educational inclusion. The information about school-based Physical Therapy development in Spain is very scarce. The objective of this study is to describe the situation of physiotherapy in educational centers and compare it among the different autonomous communities. Materials and methods. A descriptive and cross-sectional study was carried out through the elaboration of an online survey, designed together with a panel of experts using the Delphi method. Six thematic blocks were included related to the provision of the physiotherapy service, working conditions and the coverage of the students’ needs. Results. 178 responses were obtained. Their geographical distribution was homogeneous, although large differences were detected among the autonomous communities. Most of the participants work in special education centers and there are autonomous communities in which physical therapists do not work in ordinary centers. Only 28.4% answered that the physiotherapist is integrated into the educational orientation teams of their autonomous community and has the function of determining the need for the resource. Conclusions. School-based Physiotherapy services to support students with special educational needs is unequal among the autonomous communities, and in some of them it is considered insufficient

El trabajador universitario: entre el malestar y la lucha Professors: between discomfort and fight

Las modificaciones en el mundo del trabajo producidas por la crisis de acumulación capitalista han transformado así mismo las condiciones de desarrollo de la labor docente. En un mundo cada vez más complejo y competitivo, la institución universitaria es atravesada por múltiples y contradictorias exigencias que se manifiestan en la salud de sus trabajadores. Este trabajo analiza fenómenos como la precarización del trabajo docente y sus implicaciones en la salud física y mental de los trabajadores universitarios, revisando las investigaciones recientes sobre el síndrome de burnout y padecimientos similares en México. Así mismo reflexiona sobre los límites y posibilidades de la acción política emancipadora por parte de los trabajadores de la educación.<br>The crisis of capitalist accumulation has brought changes in the world of work that have also affected the working conditions of professors. In a world increasingly complex and competitive, universities are traversed by multiple and conflicting demands that have impacts on their workers' health. This paper analyzes the phenomena of precarious work in the teaching profession and its implications for the physical and mental health of university employees. It reviews recent research on the burnout syndrome and similar sufferings in Mexico to reflect on the limits and possibilities of emancipatory political action by education workers