Programa de formación de voluntariado tecnológico

La Federación Española de Ingeniería Sin Fronteras (ISF) es una organización con una fuerte base de voluntariado que lleva trabajando desde el año 1995 en la implementación de proyectos de cooperación al desarrollo, poniendo la tecnología al servicio del desarrollo humano y acumulando una destacada experiencia en áreas como agua y saneamiento, energías renovables, telecomunicaciones, servicios urbanos y desarrollo agropecuario. ISF entiende que la implementación y creación de tecnología no es neutra, sino que es dependiente del tejido sociocultural y económico en el que se desarrolla. Así pues, el Programa de Formación Tecnológico está orientado a la formación de aquellos voluntarios y voluntarias que centran su par ticipación en la aplicación de tecnologías apropiadas y que posibilitan aspectos tan fundamentales como el acceso a los servicios básicos. Existe actualmente una falta de perfiles profesionales con formación tecnológica y conocimientos en Cooperación Internacional, Desarrollo Sostenible y Tecnología y tampoco existe oferta de formación no presen cial en un ámbito tan específico como la Tecnología para el Desarrollo Humano. Estos factores han contribuido, por un lado a un aumento de la demanda de las acciones formativas incluidas en este Programa y por otro, a la ampliación del mismo con el objetivo de ofrecer una mayor especialización a los voluntarios y voluntarias con más experiencia.Postprint (published version

Promoción y aprendizaje de tecnologías para el desarrollo humano a través de la formación online

Uno de los métodos aplicados para promocionar la Tecnología para el Desarrollo Humano (TDH) es la incorporación de actividades de Educación para el Desarrollo en la formación de ingeniería. Bajo este enfoque nace y se desarrolla la oferta formativa online, impulsada por ISF y el GRECDH de la UPC. El presente trabajo, además de presentar el origen, las motivaciones, los objetivos y metodología, analiza cómo, más allá de ser un puro instrumento educativo, la formación online permite cumplir estrategias y objetivos en el campo de la Educación para el Desarrollo y en el de la promoción de la TDH con ventajas objetivas sobre la formación presencia.Postprint (published version

Model for predicting early and late-onset postoperative pulmonary complications in perioperative patients receiving neuromuscular blockade: a secondary analysis

Pulmonary complications continue to be the most common adverse event after surgery. The main objective was to carry out two independent predictive models, both for early pulmonary complications in the Post-Anesthesia Care Unit and late-onset pulmonary complications after 30 postoperative days. The secondary objective was to determine whether presenting early complications subsequently causes patients to have other late-onset events. This is a secondary analysis of a cohort study. 714 patients were divided into four groups depending on the neuromuscular blocking agent, and spontaneous or pharmacological reversal. Incidence of late-onset complications if we have not previously had any early complications was 4.96%. If the patient has previously had early complications the incidence of late-onset complications was 22.02%. If airway obstruction occurs, the risk of atelectasis increased from 6.88 to 22.58% (p = 0.002). If hypoxemia occurs, the incidence increased from 5.82 to 21.79% (p < 0.001). Based on our predictive models, we conclude that diabetes mellitus and preoperative anemia are two risk factors for early and late-onset postoperative pulmonary complications, respectively. Hypoxemia and airway obstruction in Post-Anesthesia Care Unit increased four times the risk of the development of pneumonia and atelectasis at 30 postoperative days

Neuromonitoring depth of anesthesia and its association with postoperative delirium

Delirium after surgery or Postoperative delirium (POD) is an underdiagnosed entity, despite its severity and high incidence. Patients with delirium require a longer hospital stay and present more postoperative complications, which also increases hospital costs. Given its importance and the lack of specific treatment, multifactorial preventive strategies are evidenced based. Our hypothesis is that using general anaesthesia and avoiding the maximum time in excessively deep anaesthetic planes through BIS neuromonitoring device will reduce the incidence of postoperative delirium in patients over the age of 65 and their hospitalization stay. Patients were randomly assigned to two groups: The visible BIS group and the hidden BIS neuromonitoring group. In the visible BIS group, the depth of anaesthesia was sustained between 40 and 60, while in the other group the depth of anaesthesia was guided by hemodynamic parameters and the Minimum Alveolar Concentration value. Patients were assessed three times a day by research staff fully trained during the 72 h after the surgery to determine the presence of POD, and there was follow-up at 30 days. Patients who developed delirium (n = 69) was significantly lower in the visible BIS group (n = 27; 39.1%) than in the hidden BIS group (n = 42, 60.9%; p = 0.043). There were no differences between the subtypes of delirium in the two groups. Patients in the hidden BIS group were kept for 26.6 ± 14.0 min in BIS values &lt; 40 versus 11.6 ± 10.9 min (p &lt; 0.001) for the patients in the visible BIS group. The hospital stay was lower in the visible BIS group 6.56 ± 6.14 days versus the 9.30 ± 7.11 days (p &lt; 0.001) for the hidden BIS group, as well as mortality; hidden BIS 5.80% versus visible BIS 0% (p = 0.01). A BIS-guided depth of anaesthesia is associated with a lower incidence of delirium. Patients with intraoperative neuromonitoring stayed for a shorter time in excessively deep anaesthetic planes and presented a reduction in hospital stay and mortality

Laparoscopic surgery in 3D improves results and surgeon convenience in sleeve gastrectomy for morbid obesity

Purpose Advanced laparoscopic procedures are still challenging. One critical issue is the lack of stereoscopic vision. The aim of this surgical study is to evaluate whether 3D vision offers any advantages for surgical performance over 2D vision during sleeve gastrectomy for morbid obesity using a laparoscopic system that allows changing between 2D and 3D optics. Methods A total of 78 patients were analyzed, with 37 in the 2D group and 41 in the 3D group. Performance time, hospital stay, complications, and early outcomes were collected. To assess the quality of the 2D and 3D techniques, visual analog scales from 0 to 10 were designed, and image quality, depth of field, precision in performing tasks, and general ergonomics were measured. Results According to the vision system used, the mean duration of surgery was 85 ± 16.8 min for patients operated on with the 2D system and 69 ± 16.9 min for those operated on with the 3D system. There were no significant differences between the overall percentages of complications according to the type of vision used. However, postoperative complications were more severe in the 2D laparoscopy group. The average length of stay was shorter for patients in the 3D group. Regarding the differences perceived by the surgeon, the depth of field and the precision of tasks were better in the 3D vision group. Conclusion The 3D system provided greater depth perception and precision in more complex tasks, enabling safer surgery. This led to a reduction in the operative time and hospital stay. Moreover, the severity of complications was less

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Çédille, revista de estudios franceses

Presentació

Programa de formación de voluntariado tecnológico

La Federación Española de Ingeniería Sin Fronteras (ISF) es una organización con una fuerte base de voluntariado que lleva trabajando desde el año 1995 en la implementación de proyectos de cooperación al desarrollo, poniendo la tecnología al servicio del desarrollo humano y acumulando una destacada experiencia en áreas como agua y saneamiento, energías renovables, telecomunicaciones, servicios urbanos y desarrollo agropecuario. ISF entiende que la implementación y creación de tecnología no es neutra, sino que es dependiente del tejido sociocultural y económico en el que se desarrolla. Así pues, el Programa de Formación Tecnológico está orientado a la formación de aquellos voluntarios y voluntarias que centran su par ticipación en la aplicación de tecnologías apropiadas y que posibilitan aspectos tan fundamentales como el acceso a los servicios básicos. Existe actualmente una falta de perfiles profesionales con formación tecnológica y conocimientos en Cooperación Internacional, Desarrollo Sostenible y Tecnología y tampoco existe oferta de formación no presen cial en un ámbito tan específico como la Tecnología para el Desarrollo Humano. Estos factores han contribuido, por un lado a un aumento de la demanda de las acciones formativas incluidas en este Programa y por otro, a la ampliación del mismo con el objetivo de ofrecer una mayor especialización a los voluntarios y voluntarias con más experiencia