Estudio anatomopatológico de los tumores hepáticos desarrollados sobre hígados cirróticos

Se han revisados todos los enfermos trasplantados de hígado en el H. U. Reina Sofía de Córdoba entre los años 1989 y 2005, seleccionado aquellos hígados con cirrosis y sobre los que asienta una presión tumoral, en su mayoría carcinoma hepatocelular. Los datos generales que se recogieron de cada paciente fueron: edad, sexo, tiempo de evolución, recidiva tumoral, recidiva de la enfermedad, rechazo del injerto, éxitus del paciente y causas. Realizándose un estudio macroscópico de la pieza quirúrgica, así como una revisión histológica, que incluía entre otros, el tipo tumoral, la invasción capsular o la invasción vascular. Obtuvimos 114 casos con hepatocarcinoma de entre los 650 pacientes trasplantados de hígado. En relación con un origen viral en su mayoría (virus de la hepatitis). La importancia de este estudio radica, entre otras cosas, en valorar los posibles factores pronósticos que influyen en la supervivencia del paciente transplantado y que poseen valor estadísticamente significativo. Nostros hemos encontrado dos: la recidiva de la enfermedad y la recidiva tumoral. También tiene valor estadísticamente significativo la relación que ejerce la invasión vascular sobre la recidiva tumoral

Implantación de una Política de Responsabilidad Social Corporativa Estratégica: Caso de una gran compañía multinacional japonesa del sector de la automoción.

El estudio muestra un modelo conceptual teórico de RSC estratégica desarrollado a partir de las reflexiones e ideas de otros autores. Se realiza un contraste del mismo mediante la elección de un caso real. Concretamente, se elige a una gran corporación japonesa de la automoción para explicar cómo traslada las políticas y procedimientos necesarios para su implantación a lo largo de su compleja red interna de empresas. Los aspectos más característicos y distintivos del caso se exponen finalmente en las conclusiones, indicando las posibles líneas de investigación en estudios posteriore

Monitoring the communication competence in an innovative context of project management learning

This document presents an innovative, formal educational initiative that is aimed at enhancing the development of engineering students' specific competences. The subject of project management is the common theoretical and practical framework that articulates an experience that is carried out by multidisciplinary groups. Full utilization of Web 2.0 platforms and Project Based Learning constitutes the applied methodology. More specifically, this study focuses on monitoring communication competence when working in virtual environments, providing an ad-hoc rubric as a final result

Clinical management and acute exacerbations in patients with idiopathic pulmonary fibrosis in Spain: results from the OASIS study

Clinical management; Acute exacerbations; Early treatmentGestión clínica; Exacerbaciones agudas; Tratamiento precozGestió clínica; Exacerbacions agudes; Tractament precoçBackground Idiopathic pulmonary fibrosis (IPF) is a progressive disease associated with decline in lung function and poor prognosis entailing significant impairment in quality of life and high socioeconomic burden. The aim of this study was to characterize clinical management and resources utilization of patients with IPF in Spain, according to predicted forced vital capacity (FVC) % at baseline. Methods Prospective, non-interventional, multicentric real-world data study in patients with IPF in Spain with 12-months follow-up. Clinical management and resources utilization during study period were recorded and compared between groups. FVC decline and acute exacerbations occurrence and associated healthcare resource use were also analysed. FVC decline after 12 months was estimated as relative change. Results 204 consecutive patients with IPF were included and divided according to baseline FVC % predicted value. At baseline, patients with FVC  10% in the more preserved lung function groups than in the FVC < 50% group, because of their already deteriorated condition. Conclusions We observed a significantly higher annual IPF-related resource use in patients with more impaired lung function at baseline. Since FVC decreases irrespective of FVC% predicted at baseline, slowing IPF progression to maintain patients at early disease stages is relevant to improve IPF management and to optimize resource use.The study was supported and funded by Boehringer Ingelheim España

Autocuidado en pacientes adultos con diabetes mellitus tipo 2 del Hospital San Juan de Lurigancho, 2022

La presente investigación tuvo como objetivo, describir el autocuidado en los pacientes adultos con diabetes mellitus tipo 2 del Hospital San Juan de Lurigancho, 2022. La metodología fue de tipo básica, de enfoque cuantitativo, con diseño no experimental de corte transversal descriptivo, con una muestra de 80 pacientes con diabetes mellitus tipo 2, ejecutando un muestreo no probabilístico. La técnica que se utilizó fue la encuesta mediante el cual se dio la recolección de datos, mientras que el instrumento utilizado fue el cuestionario Apreciación de Agencia de Autocuidado (ASA) diseñada por Isenberg y Evers (1993). Los resultados fueron que el 57,5% de los pacientes con diabetes mellitus tipo 2 tuvo un nivel de autocuidado regular, mientras el 35% fue bueno, el 7,5% bajo y ninguno obtuvo un nivel muy bajo. Es decir, la mayoría de los pacientes adultos con diabetes mellitus tipo 2 del hospital de San Juan de Lurigancho tienen un nivel de autocuidado regular. Concluyendo que el autocuidado en los pacientes adultos con diabetes mellitus tipo 2 del Hospital San Juan de Lurigancho, 2022, presentó un nivel de autocuidado regula

Economic Burden of Idiopathic Pulmonary Fibrosis in Spain: A Prospective Real-World Data Study (OASIS Study)

Carga económica; Fibrosis pulmonar idiopática; EspañaCàrrega econòmica; Fibrosi pulmonar idiopàtica; EspanyaEconomic burden; Idiopathic pulmonary fibrosis; SpainBackground Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal lung disease associated with dyspnoea, cough and impaired quality of life affecting around 7500 patients in Spain. Objective Our aim was to estimate the economic impact of IPF according to forced vital capacity (FVC) % predicted level in adult patients. Methods We conducted a prospective, observational, multicentric study of patients with confirmed IPF in Spain. Total annual IPF-related costs were estimated per patient, and categorised according to the FVC% predicted value (FVC 80%) and total sample. Incurred direct health- and non-health-related costs and indirect costs were calculated considering the IPF-related healthcare resource use and the corresponding unitarian costs. Results were updated to 2023 euros. Results Two hundred and four consecutive patients with IPF were included: 77% male, average age (standard deviation) 70.8 (7.6) years. At baseline, FVC% was 80% of predicted value in 10.8%, 74.5% and 14.7% of patients, respectively. The final cost-evaluable population included 180 subjects. The mean (standard deviation) total annual IPF-related cost was €26,997 (17,555), with statistically significant differences (p = 0.0002) between groups: €44,412 (33,389) for the FVC 80%. Annual direct health costs had the greatest weight and included pharmacological treatments [€22,324 (13,773)] and hospitalisation days [€1659 (7362)]. 14 patients had ≥ 1 acute exacerbation of IPF during the study; mean total cost of an acute exacerbation of IPF was €10,372. According to the multivariate analysis, an impaired lung function (FVC < 50%) and use of antifibrotic treatment were determinants of cost (p < 0.0001 both). Conclusions We observed a significantly higher annual IPF-related cost at a lower level of predicted FVC%, the direct cost having the greatest weight to the total costs. Maintaining patients at early disease stages by slowing IPF progression is relevant to reduce the economic impact of IPF

Inhibiting ethylene perception with 1-methylcyclopropene triggers molecular responses aimed to cope with cell toxicity and increased respiration in citrus fruits

The ethylene perception inhibitor 1-methylcyclopropene (1-MCP) has been critical in understanding the hormone's mode of action. However, 1-MCP may trigger other processes that could vary the interpretation of results related until now to ethylene, which we aim to understand by using transcriptomic analysis. Transcriptomic changes in ethylene and 1-MCP-treated ‘Navelate’ (Citrus sinensis L. Osbeck) oranges were studied in parallel with changes in ethylene production, respiration and peel damage. The effects of compounds modifying the levels of the ethylene co-product cyanide and nitric oxide (NO) on fruit physiology were also studied. Results suggested that: 1) The ethylene treatment caused sub-lethal stress since it induced stress-related responses and reduced peel damage; 2) 1-MCP induced ethylenedependent and ethylene-independent responsive networks; 3) 1-MCP triggered ethylene overproduction, stress-related responses and metabolic shifts aimed to cope with cell toxicity, which mostly affected to the inner part of the peel (albedo); 4) 1-MCP increased respiration and drove metabolism reconfiguration for favoring energy conservation but up-regulated genes related to lipid and protein degradation and triggered the over-expression of genes associated with the plasma membrane cellular component; 5) Xenobiotics and/or reactive oxygen species (ROS) might act as signals for defense responses in the ethylene-treated fruit, while their uncontrolled generation would induce processes mimicking cell death and damage in 1-MCP-treated fruit; 6) ROS, the ethylene co-product cyanide and NO may converge in the toxic effects of 1-MCP.This work was supported by the Spanish Ministry of Science and Technology (Research Grants AGL2002-1727 and AGL2009-11969 and by the Generalitat Valenciana, Spain (Grant PROMETEOII/2014/027). Dr. B. E. was the recipient of a fellowship of the Spanish Ministry of Science and Technology. Dr. A.R.B. is grateful to CSIC and the European Social Fund for her postdoctoral JAE-Doc contract.Peer reviewe

Critical issues and guidelines to improve the performance of photocatalytic polymeric membranes

Photocatalytic membrane reactors (PMR), with immobilized photocatalysts, play an important role in process intensification strategies; this approach offers a simple solution to the typical catalyst recovery problem of photocatalytic processes and, by simultaneous filtration and photocatalysis of the aqueous streams, facilitates clean water production in a single unit. The synthesis of polymer photocatalytic membranes has been widely explored, while studies focused on ceramic photocatalytic membranes represent a minority. However, previous reports have identified that the successful synthesis of polymeric photocatalytic membranes still faces certain challenges that demand further research, e.g., (i) reduced photocatalytic activity, (ii) photocatalyst stability, and (iii) membrane aging, to achieve technological competitiveness with respect to suspended photocatalytic systems. The novelty of this review is to go a step further to preceding literature by first, critically analyzing the factors behind these major limitations and second, establishing useful guidelines. This information will help researchers in the field in the selection of the membrane materials and synthesis methodology for a better performance of polymeric photocatalytic membranes with targeted functionality; special attention is focused on factors affecting membrane aging and photocatalyst stability.This research was funded by the Spanish Ministry of Economy, Industry and Competitiveness (MINECO-FEDER) through the projects CTM2016-75509-R and RTI2018-093310-B-I00 and by the State Research Agency (APCIN 2018) through the project X-MEM (PCI2018-092929)

Impact of the implementation of a telemedicine program on patients diagnosed with asthma.

Background: Asthma is one of the most common respiratory ailments worldwide. Despite broad understanding of the illness and of the available therapeutic options for it, patients with serious asthma suffer poor monitoring of their illness in 50% of cases. Aim: To assess the impact of the implementation of a mobile application (ESTOI) to control asthma in patients diagnosed with the illness, their adherence to treatment, and their perceived quality of life. Methodology: Randomized clinical trial with 52 weeks' follow-up of patients with asthma seen in a specialized hospital for their treatment in Spain. Some 108 included patients will be divided into two groups. The intervention group will undergo more exhaustive follow-up than normal, including access to the ESTOI application, which will have various categories of attention: control of symptoms, health recommendations, current treatment and personalized action plan, PEF record, nutritional plan, and chat access with a medical team. The asthma control questionnaire ACT is the main assessment variable. Other variables to be studied include an adherence test for the use of inhalers (TAI), the number of exacerbations, maximum exhalation flow, exhaled nitric oxide test, hospital anxiety and depression scale, asthma quality-of-life questionnaire, forced spirometry parameters (FVC, FEV1, and PBD), and analytic parameters (eosinophilia and IGE). The data will be collected during outpatient visits. Trial registration: This trial has registered at ClinicalTrials.gov (Identifier: NCT06116292)

Ciencia, tecnología y Sociedad (CTS): Miradas desde la educación superior en Ecuador

La ciencia y la tecnología han dado lugar a cambios sustanciales en la vida de los seres humanos, con una significativa contribución a su bienestar. Al mismo tiempo, han sido responsables de muchos de sus problemas y crisis actuales. Sobre esta base, se ha ido constituyendo una rama del saber entorno a la Ciencia, Tecnología y Sociedad (CTS) que estudia la relación entre estos tres elementos para crear conciencia de los riesgos que están implícitos en el desarrollo tecnológico. Como respuesta al urgente esfuerzo de reflexión y concientización que provoca la temática, un grupo de docentes de la Universidad Politécnica Salesiana del Ecuador publica este texto que recoge contribuciones de análisis y aportes para otros académicos, estudiantes e incluso instituciones sobre un problema que cada día se vuelve más actual por su impacto sobre la vida cotidiana de los seres humanos y el futuro del planeta