Prevención y comparación de infección por el virus de la gripe en la planta de neumología

Con el siguiente Plan de Mejora, queremos conocer la prevalencia de la gripe en la Unidad de Neumología del Hospital Universitario de Burgos y comparar las cifras de gripe en España durante dos años consecutivos. El principal objetivo de este proyecto, es identificar aquellos aspectos que faciliten la transmisión de la gripe debido a una mala actuación o por falta de información. Debido a esta situación, con este estudio queremos potenciar las medidas preventivas de contagio del virus y conseguir una menor incidencia de infecciones.With the following improvement plan, we want to learn about the prevalence of the influenza at the Pneumology Unit in the University Hospital of Burgos and compare the flu figures in Spain for two consecutive years. The main aim of this project, is to identify those aspects that facilitate flu transmission due to a bad action or lack of information. Because of this situation, with this research we would like to increase the preventive measures against the virus spread and achieve a lower incidence of infections

The effectiveness of Schroth method in Cobb angle, quality of life and trunk rotation angle in adolescent idiopathic scoliosis: a systematic review and meta-analysis

The Schroth method is one of the most common physiotherapeutic scoliosis-specific exercises intervention applied in adolescent idiopathic scoliosis (AIS). This method consists of three-dimensional correction of the specific curve pattern of the patient using a combination of sensorimotor, postural, and corrective breathing exercises. The aim of this systematic review and meta-analysis was to analyse the effects of the Schroth method in isolation on Cobb angle, quality of life, and trunk rotation angle compared to no intervention or other conservative treatments in patients with AIS

Systematic review and meta-analysis showed that complementary and alternative medicines were not effective for infantile colic

Aim: Osteopathy and chiropractic techniques are used for babies for different rea-sons, but it is unclear how effective they are. The aim of this study was to evaluate their effectiveness in reducing crying time and increasing sleeping time in babies with infantile colic.Methods: A systematic review and meta-analysis was conducted on infantile colic studies that used complementary and alternative medicine techniques as interven-tions. The outcome measures were hours spent crying and/or sleeping. We used the PubMed, Physiotherapy Evidence Database, Cochrane Library, Embase, Web of Science, Scopus, Osteopathic Medicine Digital Database and Google Scholar data-bases from inception to 11 November 2022.Results: The methodological quality of the randomised control trials ranged from fair to high. We focused on five studies with 422 babies. Complementary treatments failed to decrease the crying time (mean difference −1.08, 95% CI: −2.17 to 0.01, I2= 92%) and to increase sleeping time (mean difference 1.11, 95% CI: −0.20 to 2.41; I2: 91%), compared with no intervention. The quality of the evidence was rated as very low for both outcome measures.Conclusion: Osteopathy and chiropractic treatment failed to reduce the crying time and increase sleeping time in babies with infantile colic, compared with no additional intervention

Clinical and psychological variables in female patients with cervical syndromes: A cross-sectional and correlational study

Producción CientíficaBackground: The objectives of this study were: (1) to compare the pain intensity, cervical range of motion (ROM), psychological distress and kinesiophobia in patients with cervicogenic dizziness (CGD), tension-type headache (TTH), and mechanical chronic neck pain (MCNP); and (2) to investigate the relationships between pain intensity and cervical ROM and between psychological distress and kinesiophobia. Methods: a cross-sectional and correlational study was designed. In total, 109 patients (32 patients with CGD, 33 with TTH and 44 with MCNP) were included. Pain intensity, cervical ROM, psychological distress and kinesiophobia were assessed. Results: Statistically significant differences were found between the groups in pain intensity, psychological distress and kinesiophobia. The patients with MCNP showed higher pain intensity compared to the other groups (p 0.05). The CGD and MCNP groups found a moderate positive correlation between psychological distress and kinesiophobia (p < 0.05). The patients with TTH and MCNP showed a moderate positive correlation between pain intensity, psychological distress and kinesiophobia (p < 0.05). Conclusion: Pain intensity, psychological distress and kinesiophobia should be considered in the three groups. Psychological distress was correlated with kinesiophobia in the CGD and MCNP groups. The MCNP group showed a correlation between pain intensity, psychological distress and kinesiophobia

Effectiveness of physiotherapy treatment through diacutaneous fibrolysis in patient with carpal tunnel syndrome. 12 case series

The objective of the study was to analyze the effectiveness of physiotherapy treatment through diacutaneous fibrolysis in 12 case series of patients with carpal tunnel syndrome (mild to moderate intensity)

EoE CONNECT, the European Registry of Clinical, Environmental, and Genetic Determinants in Eosinophilic Esophagitis:rationale, design, and study protocol of a large-scale epidemiological study in Europe

BACKGROUND: The growing prevalence of eosinophilic esophagitis (EoE) represents a considerable burden to patients and health care systems. Optimizing cost-effective management and identifying mechanisms for disease onset and progression are required. However, the paucity of large patient cohorts and heterogeneity of practice hinder the defining of optimal management of EoE. METHODS: EoE CONNECT is an ongoing, prospective registry study initiated in 2016 and currently managed by EUREOS, the European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract. Patients are managed and treated by their responsible specialists independently. Data recorded using a web-based system include demographic and clinical variables; patient allergies; environmental, intrapartum, and early life exposures; and family background. Symptoms are structurally assessed at every visit; endoscopic features and histological findings are recorded for each examination. Prospective treatment data are registered sequentially, with new sequences created each time a different treatment (active principle, formulation, or dose) is administered to a patient. EoE CONNECT database is actively monitored to ensure the highest data accuracy and the highest scientific and ethical standards. RESULTS: EoE CONNECT is currently being conducted at 39 centers in Europe and enrolls patients of all ages with EoE. In its aim to increase knowledge, to date EoE CONNECT has provided evidence on the effectiveness of first- and second-line therapies for EoE in clinical practice, the ability of proton pump inhibitors to induce disease remission, and factors associated with improved response. Drug effects to reverse fibrous remodeling and endoscopic features of fibrosis in EoE have also been assessed. CONCLUSION: This prospective registry study will provide important information on the epidemiological and clinical aspects of EoE and evidence as to the real-world and long-term effectiveness and safety of therapy. These data will potentially be a vital benchmark for planning future EoE health care services in Europe

EoE CONNECT, the European Registry of Clinical, Environmental, and Genetic Determinants in Eosinophilic Esophagitis: rationale, design, and study protocol of a large-scale epidemiological study in Europe

Background: The growing prevalence of eosinophilic esophagitis (EoE) represents a considerable burden to patients and health care systems. Optimizing cost-effective management and identifying mechanisms for disease onset and progression are required. However, the paucity of large patient cohorts and heterogeneity of practice hinder the defining of optimal management of EoE. Methods: EoE CONNECT is an ongoing, prospective registry study initiated in 2016 and currently managed by EUREOS, the European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract. Patients are managed and treated by their responsible specialists independently. Data recorded using a web-based system include demographic and clinical variables; patient allergies; environmental, intrapartum, and early life exposures; and family background. Symptoms are structurally assessed at every visit; endoscopic features and histological findings are recorded for each examination. Prospective treatment data are registered sequentially, with new sequences created each time a different treatment (active principle, formulation, or dose) is administered to a patient. EoE CONNECT database is actively monitored to ensure the highest data accuracy and the highest scientific and ethical standards. Results: EoE CONNECT is currently being conducted at 39 centers in Europe and enrolls patients of all ages with EoE. In its aim to increase knowledge, to date EoE CONNECT has provided evidence on the effectiveness of first- and second-line therapies for EoE in clinical practice, the ability of proton pump inhibitors to induce disease remission, and factors associated with improved response. Drug effects to reverse fibrous remodeling and endoscopic features of fibrosis in EoE have also been assessed. Conclusion: This prospective registry study will provide important information on the epidemiological and clinical aspects of EoE and evidence as to the real-world and long-term effectiveness and safety of therapy. These data will potentially be a vital benchmark for planning future EoE health care services in Europe

Accurate and timely diagnosis of Eosinophilic Esophagitis improves over time in Europe. An analysis of the EoE CONNECT Registry

BACKGROUND: Poor adherence to clinical practice guidelines for eosinophilic esophagitis (EoE) has been described and the diagnostic delay of the disease continues to be unacceptable in many settings. OBJECTIVE: To analyze the impact of improved knowledge provided by the successive international clinical practice guidelines on reducing diagnostic delay and improving the diagnostic process for European patients with EoE. METHODS: Cross‐sectional analysis of the EoE CONNECT registry based on clinical practice. Time periods defined by the publication dates of four major sets of guidelines over 10 years were considered. Patients were grouped per time period according to date of symptom onset. RESULTS: Data from 1,132 patients was analyzed and median (IQR) diagnostic delay in the whole series was 2.1 (0.7‐6.2) years. This gradually decreased over time with subsequent release of new guidelines (p < 0.001), from 12.7 years up to 2007 to 0.7 years after 2017. The proportion of patients with stricturing of mixed phenotypes at the point of EoE diagnosis also decreased over time (41.3% vs. 16%; p < 0.001), as did EREFS scores. The fibrotic sub‐score decreased from a median (IQR) of 2 (1‐2) to 0 (0‐1) when patients whose symptoms started up to 2007 and after 2017 were compared (p < 0.001). In parallel, symptoms measured with the Dysphagia Symptoms Score reduced significantly when patients with symptoms starting before 2007 and after 2012 were compared. A reduction in the number of endoscopies patients underwent before the one that achieved an EoE diagnosis, and the use of allergy testing as part of the diagnostic workout of EoE, also reduced significantly over time (p = 0.010 and p < 0.001, respectively). CONCLUSION: The diagnostic work‐up of EoE patients improved substantially over time at the European sites contributing to EoE CONNECT, with a dramatic reduction in diagnostic delay

Relativismo y racionalidad

¿Qué quiere decir que el hombre es un ser racional? ¿Hay una o muchas racionalidades? ¿Son los límites de lo que podemos decir sobre la realidad también los límites de la realidad? ¿Es la percepción de algo real la garantía de que todos percibimos lo mismo? ¿Son la explicación y la compresión formas de justificación dependientes de contextos culturales, de la escogencia más o menos convencional de modelos de explicación, o de estructuras de comprensión universal? ¿Hay una verdad y una realidad en la matemática con independencia de nuestras formas de razonar, relacionadas de algún modo con nuestras formas de vida?. / Contenido. Preliminares; Capítulo 1 - Relativismo y escepticismo. Interpretando al otro: comunicación, racionalidad y relativismo, pág. 19; Interpretando al otro: imperialismo conceptual y relativismo como síntomas, pág. 41; Realismo, esencialismo y extensionalismo, pág. 67; ¿Hay algo más allá de lo que podemos decir?, pág. 95; Percepción e inconmensurabilidad, pág. 101; Contenido no conceptual, modularidad y distintos tipos de ver, pág. 121; Dudas y sospechas, pág. 129; Dudas y sospechas sobre "Dudas y sospechas", pág. 145; Racionalidad y eficacia crítica en una historia multívoca, pág. 165 Capítulo 2 – Racionalidad práctica. Razones internas vs razones externas. Reflexiones sobre una distinción, pág. 181; Razones y motivos para actuar, pág. 195; La paradoja de la irracionalidad según Donald Davidson, pág. 215; Identidad personal e imaginación práctica, pág. 235 Capítulo 3 – Filosofía del lenguaje, de la lógica y de la matemática. La explicitación de las reglas: un problema para la pragmática normativa, pág. 271; Acerca de la normatividad de la semántica, pág. 293; La forma lógica en el Tractatus: sintaxis y semántica, pág. 299 Semántica y aplicación de la lógica, pág. 313; Necesidad lógica e historias naturales ficticias en el Wittgenstein tardío, pág. 323; Realismo y racionalismo en la matemática, pág. 337; El lenguaje y la realidad de la matemática, pág. 351 Capítulo 4 – Explicación teórica. Explicación contextualista y ratificación etnocéntrica de los criterios de justificación, pág. 367; La explicación científica: causalidad, unificación y subsunción teórica, pág. 383; Limites de la explicación como subsunción, pág. 41

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters

This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher PDFPeer reviewe