Nivel de conocimientos de estudiantes de enfermería acerca de la prevención de los defectos del tubo neural

Treball Final de Grau en Infermeria. Codi: IN1138. Curs: 2017/2018Introduction: Neural tube defects (NTD) are congenital defects of the brain, spine, and spinal cord. The most common are spina bifida and anencephaly. They occur around day 28 of gestation and occur when the neural tube does not close completely. The exact causes are no t known and there is no cure, but according to research, the intake of 400 micrograms of folic acid from before pregnancy until 12 weeks of it, prevents most NTDs. Hypothesis : Information about the prevention of NTDs is insufficient. Goals: Know the level of knowledge of the 1st and 4th graders of the Nursing Degree at the Jaime I. University. Observe if knowledge is acquired during training. Methodology: Observational, descriptive and transversal study, a questionnaire is administered to students before classes. Results: The hypothesis is confirmed, only 19.3% have sufficient knowledge. During the degree if knowledge is acquired since the average increases 1 point. Conclusion: The sample has an average age of 22.96 years, only 9.3% have children. The majo rity of them have access to a baccalaureate of 73.2% and the knowledge was acquired during training in 83.5%. Of the total sample, women represent 76.3%. No significant statistical significance is obtained between variables and score. It is considered necessary to establish effective intervention strategies to reduce the incidence of NTD, since it is a potentially preventable cause.Introducción : Los defectos del tubo neural (DTN) son defectos congénitos del cerebro, la columna vertebral y la médula espinal. Los más comunes son la espina bífida y la anencefalia. Se producen alrededor del día 28 de la gestación y ocurren cuando el tubo neural no se cierra por completo. No se conocen las causas exactas y no hay cura, pero según investigaciones, la ingesta de 400 microgramos de ácido fólico desde antes del embarazo h asta cumplir 12 semanas del mismo , previene la mayoría de los DTN. Hipótesis: La información acerca de la prevención de los DTN es insuficiente. Objetivos: Conocer el nivel de conocimientos de los alumnos de 1º y 4º del Grado de Enfermería de la U niver sidad J aime I. Observar si se adquieren conocimientos durante la formación. Metodología: E studio observacional, descriptivo y transversal, se administra un cuestionario a los alumnos antes de las clases . Resultados: Se c onfirma la hipótesis, solo el 19,3 % tiene conocimientos suficientes. Durante la titulación si se adquieren conocimientos ya que la media aumenta 1 punto. Conclusión : L a muestra tiene una media de edad de 22,96 años, solo el 9,3 % tiene hijos. La mayoría acceden desde bachillerato 7 3,2 % y los conocimientos fueron adquiridos durante la formación en el 83,5 %. Del total de la muestra las mujeres representan el 76,3 %. No se obtiene significación estadística relevante entre variables y puntuación. Se considera necesario establecer estr ategias de intervención eficaces para reducir la incidencia de DTN, ya que es una causa potencialmente prevenible

Factors related to survival in hepatocellular carcinoma in the geographic area of Sabadell (Catalonia, Spain) Factores relacionados con la supervivencia en el carcinoma hepatocelular en el área geográfica de Sabadell

Background: hepatocellular carcinoma (HCC) is a very frequent tumor. Screening for the disease is effective, but the prognostic factors are difficult to evaluate. Objectives: 1. To determine epidemiological data and the clinical course of HCC in our setting. 2. To compare patient survival according to whether screening is performed or not. 3. To evaluate survival prognostic factors. Patients and methods: data on the epidemiology and clinical course of patients diagnosed with HCC were collected on a prospective basis (January 2004-December 2006). Two groups were considered according to whether screening had been performed (group A) or not (group B). Results: a total of 110 patients were diagnosed with HCC (70% males). The most common etiology of cirrhosis was hepatitis C (56.1%), and 69% presented mild liver failure (Child-Pugh grade A). The median follow-up was 1.8 years. Fifty-one percent had been subjected to screening. The diagnosis of HCC was established by imaging techniques in 48.2% of the cases, and by histological criteria in 51.8%. The median tumor size was 23 mm in group A and 28 mm in group B (p = 0.005). Treatment with curative intent was provided in 72% of the cases in group A and in 48% in group B (p = 0.011). The median overall survival was 1.99 years-2.67 years in group A and 1.75 years in group B (p = 0.05). The multivariate analysis of overall survival showed the type of treatment (OR = 2.82 95%CI: 1.3-6.12, p = 0.009) and liver function (OR = 1.71 95%CI: 1.1-2.68, p = 0.020) to be independent predictors of survival. Conclusions: screening allows the diagnosis of smaller lesions and a higher percentage of curative treatments. The degree of liver function and the provision of curative treatment are independent predictors of survival.Introducción: el carcinoma hepatocelular (CHC) es un tumor muy prevalente. Su cribado es eficaz, pero los factores pronósticos son difíciles de evaluar. Objetivos: 1. Conocer datos epidemiológicos y evolución clínica en nuestra área. 2. Comparar la supervivencia de los pacientes según si seguían cribado o no. 3. Evaluar los factores pronósticos de supervivencia. Pacientes y métodos: se recogieron prospectivamente (enero 2004-diciembre 2006) datos epidemiológicos y evolución clínica de pacientes diagnosticados de CHC. Se estudiaron dos grupos en función del cribado (grupo A = cribado, grupo B = sin cribado). Resultados: 110 pacientes fueron diagnosticados de CHC (70% hombres). La etiología más frecuente de la cirrosis fue por virus C en 56,1%, eran Child A el 69%. El seguimiento mediano fue de 1,8 años. El 51% estaban en programa de cribado. El diagnóstico de CHC fue mediante pruebas de imagen en el 48,2% y 51,8% por criterios histológicos. El tamaño tumoral mediano fue 23 mm en el grupo A y de 28 mm en el B (p = 0,005). El tratamiento con intención curativa fue del 72% en el A y del 48% en el B (p = 0,011). La supervivencia global mediana fue de 1,99 años: grupo A. 2,67 años y grupo B 1,75 años (p = 0,05). El análisis multivariado de la supervivencia global evidenció que el tipo de tratamiento -OR = 2,82 (IC 95%: 1,3-6,12) (p = 0,009)- y la funcionalidad hepática -OR = 1,71 (IC 95%: 1,1-2,68) (p= 0,020)- predicen independientemente la supervivencia. Conclusiones: el cribado permite el diagnóstico de lesiones de menor tamaño y mayor porcentaje de tratamientos curativos. De forma independiente el grado de función hepática y la realización de un tratamiento curativo predicen la supervivencia

Immunogenicity and Safety of Three Doses of a Bivalent (B:4:P1.19,15 and B:4:P1.7-2,4) Meningococcal Outer Membrane Vesicle Vaccine in Healthy Adolescents

An experimental bivalent meningococcal outer membrane vesicle (OMV) vaccine (B:4:P1.19,15 and B:4:P1.7-2,4) has been developed to provide wide vaccine coverage particularly of the circulating strains in Europe. A randomized, controlled phase II study (study identification number, 710158/002; ClinicalTrials.gov identifier number, NCT00137917) to evaluate the immunogenicity and safety of three doses of the OMV vaccine when given to healthy 12- to 18-year-olds on a 0-2-4 month (n = 162) or 0-1-6 month schedule (n = 159). A control group received two doses of hepatitis A and one of conjugated meningococcal serogroup C vaccine on a 0-1-6 month schedule (n = 157). Immune response, defined as a fourfold increase in serum bactericidal titer using a range of vaccine-homologous or PorA-related and heterologous strains, was determined for samples taken before and 1 month after vaccination; assays were performed at two laboratories. As measured at the GlaxoSmithKline (GSK) laboratory, the OMV vaccine induced an immune response against homologous or PorA-related strains (in at least 51% of subjects against strains of serosubtype P1.19,15 and at least 66% against strains of serosubtype P1.7-2,4) and against a set of three heterologous strains (in 28% to 46% of subjects). Both laboratories showed consistent results for immune response rates. The OMV vaccine had a similar reactogenicity profile for each schedule. Pain preventing normal activities occurred in approximately one-fifth of the subjects; this was significantly higher than in the control group. The immune responses induced by the bivalent OMV vaccine demonstrated the induction of bactericidal antibodies against the vaccine-homologous/PorA-related strains but also against heterologous strains, indicating the presence of protective antigens in OMVs and confirming the potential of clinical cross-protection

UE POWER DECK. Baraja de gamificación del Plan de Ciencias

La baraja de gamificación Basic Science Power Deck es un elemento de dinamización de las clases que busca generar interacción profesor-estudiante. Cuando enfrentado a una pregunta cualquiera lanzada por el profesor durante una clase, el estudiante, generalmente, se encuentra en una situación que percibe como desventajosa. Contestar correctamente no tiene repercusión (más allá de la satisfacción personal), pero equivocarse frente a compañeros y profesor le supone subrayar públicamente su falta.SIN FINANCIACIÓNNo data 2016UE

Juntas / Juntes

Multitud d'autores i autors aporten píndoles de microliteratura, de gèneres diversos, al tercer volum amb què l'Institut Universitari d'Estudis Feministes i de Gènere Purificación Escribano vol respondre al desafiament per l'eradicació de la violència contra les dones.Tercer desafío por la erradicación de la violencia contra las mujeres del Institut Universitari d'Estudis Feministes i de Gènere Purificación Escribano de la Universitat Jaume I a través de microliteratura

Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR): study protocol for a randomized controlled trial

Background: Postoperative pulmonary complications (PPC) may result in longer duration of in-hospital stay and even mortality. Both thoracic surgery and intraoperative mechanical ventilation settings add considerably to the risk of PPC. It is unclear if one-lung ventilation (OLV) for thoracic surgery with a strategy of intraoperative high positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM) reduces PPC, compared to low PEEP without RM. Methods: PROTHOR is an international, multicenter, randomized, controlled, assessor-blinded, two-arm trial initiated by investigators of the PROtective VEntilation NETwork. In total, 2378 patients will be randomly assigned to one of two different intraoperative mechanical ventilation strategies. Investigators screen patients aged 18 years or older, scheduled for open thoracic or video-assisted thoracoscopic surgery under general anesthesia requiring OLV, with a maximal body mass index of 35 kg/m2, and a planned duration of surgery of more than 60 min. Further, the expected duration of OLV shall be longer than two-lung ventilation, and lung separation is planned with a double lumen tube. Patients will be randomly assigned to PEEP of 10 cmH2O with lung RM, or PEEP of 5 cmH2O without RM. During two-lung ventilation tidal volume is set at 7 mL/kg predicted body weight and, during OLV, it will be decreased to 5 mL/kg. The occurrence of PPC will be recorded as a collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion: PROTHOR is the first randomized controlled trial in patients undergoing thoracic surgery with OLV that is adequately powered to compare the effects of intraoperative high PEEP with RM versus low PEEP without RM on PPC. The results of the PROTHOR trial will support anesthesiologists in their decision to set intraoperative PEEP during protective ventilation for OLV in thoracic surgery. Trial registration: The trial was registered in clinicaltrials.gov (NCT02963025) on 15 November 2016

Genome-wide association studies identify four ER negative-specific breast cancer risk loci

<p>Estrogen receptor (ER)-negative tumors represent 20-30% of all breast cancers, with a higher proportion occurring in younger women and women of African ancestry. The etiology and clinical behavior of ER-negative tumors are different from those of tumors expressing ER (ER positive), including differences in genetic predisposition. To identify susceptibility loci specific to ER-negative disease, we combined in a metaanalysis 3 genome-wide association studies of 4,193 ER-negative breast cancer cases and 35,194 controls with a series of 40 follow-up studies (6,514 cases and 41,455 controls), genotyped using a custom Illumina array, iCOGS, developed by the Collaborative Oncological Gene-environment Study (COGS). SNPs at four loci, 1q32.1 (MDM4, P= 2.1 x 10(-12) and LGR6, P = 1.4 x 10(-8)), 2p24.1 (P = 4.6 x 10(-8)) and 16q12.2 (FTO, P = 4.0 x 10(-8)), were associated with ER-negative but not ER-positive breast cancer (P> 0.05). These findings provide further evidence for distinct etiological pathways associated with invasive ER-positive and ER-negative breast cancers.</p>

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care