Mediación y sustracción internacional de menores: buenas prácticas

Grado en Derecho. Derecho Internacional Privado Grupo II, 2020-201[ES]La sustracción internacional de menores tiene su origen en el seno de los conflictos familiares que como siempre plantean numerosas complejidades para ser solucionados, y con más intensidad cuando esos conflictos ocurren entre parejas que en el momento de la ruptura tienen descendientes menores de edad. La globalización ha contribuido al incremento de parejas mixtas, en el que cada sujeto en ocasiones tiene un origen diferente, algo que complica la situación de sus hijos cuando se producen separaciones o divorcios matrimoniales. Principalmente por ese elemento sentimental, que no se aprecia en otros sectores del Derecho, es importante una especial fijación y sensibilidad por el legislador para que se vele siempre por el interés y el bienestar del menor que en algunas ocasiones es el que sale más perjudicado de las situaciones descritas

A facility and community-based assessment of scabies in rural Malawi.

Background Scabies is a neglected tropical disease of the skin, causing severe itching, stigmatizing skin lesions and systemic complications. Since 2015, the DerMalawi project provide an integrated skin diseases clinics and Tele-dermatology care in Malawi. Clinic based data suggested a progressive increase in scabies cases observed. To better identify and treat individuals with scabies in the region, we shifted from a clinic-based model to a community based outreach programme. Methodology/principal findings From May 2015, DerMalawi project provide integrated skin diseases and Tele-dermatological care in the Nkhotakota and Salima health districts in Malawi. Demographic and clinical data of all patients personally attended are recorded. Due to a progressive increase in the number of cases of scabies the project shifted to a community-based outreach programme. For the community outreach activities, we conducted three visits between 2018 to 2019 and undertook screening in schools and villages of Alinafe Hospital catchment area. Treatment was offered for all the cases and school or household contacts. Scabies increased from 2.9% to 39.2% of all cases seen by the DerMalawi project at clinics between 2015 to 2018. During the community-based activities approximately 50% of the population was assessed in each of three visits. The prevalence of scabies was similar in the first two rounds, 15.4% (2392) at the first visit and 17.2% at the second visit. The prevalence of scabies appeared to be lower (2.4%) at the third visit. The prevalence of impetigo appeared unchanged and was 6.7% at the first visit and 5.2% at the final visit. Conclusions/significance Prevalence of scabies in our setting was very high suggesting that scabies is a major public health problem in parts of Malawi. Further work is required to more accurately assess the burden of disease and develop appropriate public health strategies for its control

Apnea obstructiva de sueño

[EN] predominantly obstructive or AHI greater than 5 with symptoms, the classic symptoms are observed apneas, daytime sleepiness and snoring, however, there are many other associated symptoms. To assess the severity of OSA, classically, only the AHI value was considered, but there is increasing evidence to implicate other factors. The predisposition to develop OSA is determined by anatomical and functional features. Having OSA increases the risk of accidents, high blood pressure (HBP) and is associated with cardiovascular risk, diabetes mellitus (DM), cardiac arrhythmia and neoplasms. To assess the probability of OSA, questionnaires and scales have been developed to assess symptoms, the certain diagnosis is obtained by polysomnography (PSG), which is the gold standard test, or polygraphy, which is a simpler and more accessible diagnostic test for diagnosis validated, the use of one or the other will depend on the suspicion and the associated comorbidities. Treatments for sleep apnea increasingly tend to be more individualized based on the characteristics of the patient and all are complementary. Hygienic-dietary measures should be applied in all patients, continuous positive airway pressure (CPAP) is the most effective treatment and with the most evidence, but other treatments are also available such as mandibular advancement devices (MAD), postural therapy and surgical options among others. Telemedicine is advancing in the follow-up of patients with OSA, both from non-face-to-face consultations and control of equipment via Wi-Fi to assess adherence, efficacy and correct control of therapy.[ES] La apnea obstructiva de sueño (AOS) se define como la presencia de un índice de apneas-hiponeas (IAH)>15/h, predominantemente obstructivas o IAH mayor de 5 con síntomas, los síntomas clásicos son apneas observadas, somnolencia diurna y roncopatía, no obstante, hay muchos otros síntomas asociados. Para valorar la gravedad de AOS clásicamente se atendía únicamente al valor de IAH pero cada vez hay mayor evidencia en implicar otros factores. La predisposición para desarrollar AOS viene determinado por rasgos anatómicos y funcionales. Padecer AOS aumenta el riesgo de accidentes, hipertensión arterial (HTA) y se asociado con riesgo cardiovascular, diabetes mellitus (DM), arrítmica cardiaca y neoplasias. Para valorar la probabilidad de AOS se han desarrollado cuestionarios y escalas para valorar síntomas, el diagnóstico de certeza se obtiene mediante polisomnografía (PSG) que es la prueba gold standard, o bien la poligrafía que es una prueba diagnóstica más simple y accesible para el diagnóstico validada, la utilización de una u otra dependerá de la sospecha y las comorbilidades asociadas. Los tratamientos para la apnea del sueño cada vez tienden a ser más individualizado en función de las características del paciente y todos son complementarios. Las medidas higiénico-dietéticas debe aplicarse en todos los pacientes, la presión positiva continua en la vía respiratoria (CPAP) es el tratamiento más efectivo y con mayor evidencia, pero también se dispone de otros tratamientos como los dispositivos de avance mandibular (DAM), la terapia postural y opciones quirúrgicas entre otros. La telemedicina está avanzando en el seguimiento de los pacientes con AOS, tanto desde las consultas no presenciales como el control de los equipos mediante wifi para valorar la adherencia, eficacia y correcto control de la terapia.Peer reviewe

Patients attended: Scabies, Impetigo and demographic data

A dataset that contains information on patients who received a facility or community-based assessment of Scabies . It contains six variables – age, gender, scabies assessment status, impetigo assessment status, site location, and treatment round number. Data was collected by the DerMalawi project through integrated skin diseases clinics and Tele-dermatology care that they established in 2015 in the Nkhotakota and Salima health districts in Malawi

A facility and community-based assessment of scabies in rural malawi

Altres ajuts: CantabriaLabs; Martiderm; Italfarmaco; Fundación CSAI; Ayuntamiento de Villanueva de la Cañada; Spanish Academy of Dermatology (CG); Colegio Oficial de Médicos de Madrid (CG); Fundación Mutua Madrileña (CG); Celia Delgado Matías Association; Universidad de Salamanca.Background Scabies is a neglected tropical disease of the skin, causing severe itching, stigmatizing skin lesions and systemic complications. Since 2015, the DerMalawi project provide an integrated skin diseases clinics and Tele-dermatology care in Malawi. Clinic based data suggested a progressive increase in scabies cases observed. To better identify and treat individuals with scabies in the region, we shifted from a clinic-based model to a community based outreach programme. Methodology/Principal findings From May 2015, DerMalawi project provide integrated skin diseases and Tele-dermatologi-cal care in the Nkhotakota and Salima health districts in Malawi. Demographic and clinical data of all patients personally attended are recorded. Due to a progressive increase in the number of cases of scabies the project shifted to a community-based outreach programme. For the community outreach activities, we conducted three visits between 2018 to 2019 and undertook screening in schools and villages of Alinafe Hospital catchment area. Treatment was offered for all the cases and school or household contacts. Scabies increased from 2.9% to 39.2% of all cases seen by the DerMalawi project at clinics between 2015 to 2018. During the community-based activities approximately 50% of the population was assessed in each of three visits. The prevalence of scabies was similar in the first two rounds, 15.4% (2392) at the first visit and 17.2% at the second visit. The prevalence of scabies appeared to be lower (2.4%) at the third visit. The prevalence of impetigo appeared unchanged and was 6.7% at the first visit and 5.2% at the final visit. Conclusions/Significance Prevalence of scabies in our setting was very high suggesting that scabies is a major public health problem in parts of Malawi. Further work is required to more accurately assess the burden of disease and develop appropriate public health strategies for its control

Documento internacional de consenso sobre apnea obstructiva del sueño.

The main aim of this international consensus document on obstructive sleep apnea is to provide guidelines based on a critical analysis of the latest literature to help health professionals make the best decisions in the care of adult patients with this disease. The expert working group was formed primarily of 17 scientific societies and 56 specialists from a wide geographical area (including the participation of 4 international societies), an expert in methodology, and a documentalist from the Iberoamerican Cochrane Center. The document consists of a main section containing the most significant innovations and a series of online manuscripts that report the systematic literature searches performed for each section of the international consensus document. This document does not discuss pediatric patients or the management of patients receiving chronic non-invasive mechanical ventilation (these topics will be addressed in separate consensus documents)