Introduction of a continuous medical training activity and evaluation of its quality in the Primary Care Emergency Services of Cantabria, Spain

Objetivo: Evaluación de la puesta en marcha de una actividad formativa para profesionales delos servicios de urgencia de atención primaria (SUAP) que les dote de las herramientas necesariaspara la resolución in situ de los procesos urgentes, con los medios y recursos disponibles en cadacentro.Método: Cuestionario anónimo de valoración de la actividad realizada durante cada una de lassesiones del a?no 2015. Dicho cuestionario fue cumplimentado al final de cada sesión, permi-tiendo valorar a los docentes de manera individualizada.Resultados: La plantilla de los SUAP de Cantabria es de 123 médicos y 123 profesionales deenfermería. De ellos han asistido a las sesiones un total de 178 profesionales (72% de la plantilla).De los asistentes han cumplimentado la encuesta de valoración de la actividad una media de 143profesionales (80% del total de asistentes), 81% mujeres y 19% varones. El 58% de los asistenteseran médicos de familia y el 42% personal de enfermería. En cuanto a los resultados del programaresaltaban el interés del curso para su actividad profesional (96%), si recomendaría el curso asus compa?neros (94%) y la satisfacción de haber realizado el curso (94%).Conclusiones: La puesta en marcha de actividades formativas en los SUAP ha sido percibidacomo muy favorable por los profesionales encuestados.Objective: An evaluation was performed on the introduction of a training activity for professio-nals of the Primary Care Emergency Services (SUAP) in order to equip them with the necessarytools for the on-site resolution of urgent processes, and with the resources available in eachcentre.Method: An anonymous questionnaire was used to assess the activity performed during eachof the sessions of the year 2015. This questionnaire was completed at the end of each session,allowing the assessment of individual teachers.Results: The staff of the SUAP in Cantabria included 123 physicians and 123 nursing profes-sionals. A total of 178 professionals attended the sessions (72% of the workforce). A total of143 professionals (80% of the total attendees), 81% female and 19% male, were included in thesurvey. Just over half (58%) of the attendees were family physicians and 42% were nurses. Themajor results of the program were as follows: the interest of the course for their professionalactivity (96%), they would recommend the course to their colleagues (94%), and the satisfactionof having completed the course (94%).Conclusions: The introduction of training activities in the SUAP has been perceived as veryfavourable by the professionals surveye

Mitochondrial and autophagic alterations in skin fibroblasts from Parkinson disease patients with Parkin mutations.

PRKN encodes an E3-ubiquitin-ligase involved in multiple cell processes including mitochondrial homeostasis and autophagy. Previous studies reported alterations of mitochondrial function in fibroblasts from patients with PRKN mutation-associated Parkinson's disease (PRKN-PD) but have been only conducted in glycolytic conditions, potentially masking mitochondrial alterations. Additionally, autophagy flux studies in this cell model are missing.We analyzed mitochondrial function and autophagy in PRKN-PD skin-fibroblasts (n=7) and controls (n=13) in standard (glucose) and mitochondrial-challenging (galactose) conditions.In glucose, PRKN-PD fibroblasts showed preserved mitochondrial bioenergetics with trends to abnormally enhanced mitochondrial respiration that, accompanied by decreased CI, may account for the increased oxidative stress. In galactose, PRKN-PD fibroblasts exhibited decreased basal/maximal respiration vs. controls and reduced mitochondrial CIV and oxidative stress compared to glucose, suggesting an inefficient mitochondrial oxidative capacity to meet an extra metabolic requirement. PRKN-PD fibroblasts presented decreased autophagic flux with reduction of autophagy substrate and autophagosome synthesis in both conditions.The alterations exhibited under neuron-like oxidative environment (galactose), may be relevant to the disease pathogenesis potentially explaining the increased susceptibility of dopaminergic neurons to undergo degeneration. Abnormal PRKN-PD phenotype supports the usefulness of fibroblasts to model disease and the view of PD as a systemic disease where molecular alterations are present in peripheral tissues

Programa de desarrollo de sistemas integrales de infraestructura y movilidad colectiva. Nuevas formas de movilidad para la vida

Las poblaciones urbanas padecen diversos problemas ambientales, de salud, segregación y pérdida de espacios públicos, derroche energético, ruido, así como altas inversiones de tiempo y dinero. Estas situaciones poseen un denominador común: una tecnología inadecuada llamada automóvil unipersonal. Buscamos intervenir tecnológicamente el contexto de las ciudades mediante un sistema de movilidad público, eficiente, no invasivo, silencioso, de bajo costo, saludable y ecológico. En este trabajo presentamos diferentes soluciones, con la intención de ir llevando esta tecnología hacia su transferencia tecnológica.ITESO, A.C.CoecytjalIngenieros Sin Frontera

Criterios de ordenación temporal de las intervenciones quirúrgicas en patología cardiovascular y endovascular adquirida. Versión 2022

Waiting list management of cardiac surgical procedures is a main concern for all the Spanish autonomic health systems and for our scientific Society. The first statement for optimal timing of patients waiting for cardiac surgery was published in 2000. Since then, after significant changes in the management of some pathologies, new normative frameworks and the current healthcare situation, a review of the timing criteria to offer an adequate and updated standard of care is needed. In this document we aim to review the available literature in the field and stablish a consensus within a working group of the Spanish Society of Cardiovascular and Endovascular Surgery to optimize the priority recommendations in cardiac surgical waiting lists in our country. (c) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ riccuses/by-nc-nri/4.0/)

Disrupted mitochondrial and metabolic plasticity underlie comorbidity between age-Related and degenerative disorders as parkinson disease and type 2 diabetes mellitus.

Idiopathic Parkinson's disease (iPD) and type 2 diabetes mellitus (T2DM) are chronic, multisystemic, and degenerative diseases associated with aging, with eventual epidemiological co-morbidity and overlap in molecular basis. This study aims to explore if metabolic and mitochondrial alterations underlie the previously reported epidemiologic and clinical co-morbidity from a molecular level. To evaluate the adaptation of iPD to a simulated pre-diabetogenic state, we exposed primary cultured fibroblasts from iPD patients and controls to standard (5 mM) and high (25 mM) glucose concentrations to further characterize metabolic and mitochondrial resilience. iPD fibroblasts showed increased organic and amino acid levels related to mitochondrial metabolism with respect to controls, and these differences were enhanced in high glucose conditions (citric, suberic, and sebacic acids levels increased, as well as alanine, glutamate, aspartate, arginine, and ornithine amino acids; p-values between 0.001 and 0.05). The accumulation of metabolites in iPD fibroblasts was associated with (and probably due to) the concomitant mitochondrial dysfunction observed at enzymatic, oxidative, respiratory, and morphologic level. Metabolic and mitochondrial plasticity of controls was not observed in iPD fibroblasts, which were unable to adapt to different glucose conditions. Impaired metabolism and mitochondrial activity in iPD may limit energy supply for cell survival. Moreover, reduced capacity to adapt to disrupted glucose balance characteristic of T2DM may underlay the co-morbidity between both diseases. Conclusions: Fibroblasts from iPD patients showed mitochondrial impairment, resulting in the accumulation of organic and amino acids related to mitochondrial metabolism, especially when exposed to high glucose. Mitochondrial and metabolic defects down warding cell plasticity to adapt to changing glucose bioavailability may explain the comorbidity between iPD and T2DM

The management of Solid Resources for the creation of optimal learning environments

A nivel mundial existe una problemática de contaminación ambiental, generada por las actividades humanas, en gran medida por el manejo inapropiado de residuos sólidos, por lo cual se pretende que desde las instituciones educativas se generen estrategias pedagógicas que fomenten en los estudiantes actitudes pro ambientales, para preservar su entorno. El estudio tuvo como propósito fomentar el manejo de recursos sólidos para la creación de ambientes óptimos de aprendizaje. La metodología se orientó bajo el enfoque cualitativo, utilizando el tipo de investigación acción, desde un diseño descriptivo, exploratorio. Para la recolección de datos se utilizaron técnicas como; observación participante y diario de campo. Se escogió una muestra de veinticuatro (24) estudiantes desde primero de primaria hasta octavo de básica secundaria de la Institución Educativa Departamental Macondo de la Sede Escuela Rural de varones José celestino Mutis. Se evidencio un manejo integral de los residuos sólidos como parte del proceso de aprendizaje de la institución, llegando a conclusiones con una importancia en la trasformación de los residuos sólidos que mejoren el ambiente escolar.At a global level there is a problem of environmental pollution, generated by human activities, largely due to the improper handling of solid waste, which is why educational institutions are expected to generate pedagogical strategies that encourage students to adopt environmental attitudes, to preserve its environment. The purpose of the study was to promote the management of solid resources for the creation of optimal learning environments. The methodology was oriented under the qualitative approach, using the type of action research, from a descriptive, exploratory design. For the collection of data, techniques such as; participant observation and field diary. A sample of twenty-four (24) students from elementary school to eleventh secondary school was chosen from the Macondo Departmental Educational Institution of the Jose Celestino Mutis Rural School for males. An integral management of solid waste was evidenced as part of the learning process of the institution, reaching conclusions with an importance in the transformation of solid waste that improve the school environment

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio