Needs and Expectations of Long-Term Cancer Survivors: Multi-Centre Study Protocol.

Cancer is a social issue as its outreach affects not only mortality (it is the second cause of death in our environment) but also the costs due to morbidity and the distress it causes, as well as the losses and consequences in personal, family, work, and even social areas. This study is trying to find out the health needs of long-term cancer survivors and their perceptions and expectations of the care they received during their survival stage. For this, a joint, cross-sectional descriptive study with a qualitative and quantitative approach has been designed. For the qualitative approach, we have used different focus groups representing different geographical areas of the Spanish territory. For the qualitative approach, we have used a validated questionnaire. This study will provide a better knowledge of the quality of life of these patients, as well as their level of unmet and even unexpressed needs, in order to develop effective strategies and interventions that allow for the implementation of adapted care plans that include such unexpressed needs. This study will also allow for the creation and development of assessment methods for health results from the patient's perspective and experience. These issues require a multidisciplinary, complex approach. These survivors may require not well-known health services, as the number of these patients has grown recently, and their survival time is also longer. This research explores a wider and more thorough perspective of long-term cancer survivors' needs, experiences, and expectations to be achieved

Needs and Expectations of Long-Term Cancer Survivors: Multi-Centre Study Protocol

Cancer is a social issue as its outreach affects not only mortality (it is the second cause of death in our environment) but also the costs due to morbidity and the distress it causes, as well as the losses and consequences in personal, family, work, and even social areas. This study is trying to find out the health needs of long-term cancer survivors and their perceptions and expectations of the care they received during their survival stage. For this, a joint, cross-sectional descriptive study with a qualitative and quantitative approach has been designed. For the qualitative approach, we have used different focus groups representing different geographical areas of the Spanish territory. For the qualitative approach, we have used a validated questionnaire. This study will provide a better knowledge of the quality of life of these patients, as well as their level of unmet and even unexpressed needs, in order to develop effective strategies and interventions that allow for the implementation of adapted care plans that include such unexpressed needs. This study will also allow for the creation and development of assessment methods for health results from the patient’s perspective and experience. These issues require a multidisciplinary, complex approach. These survivors may require not well-known health services, as the number of these patients has grown recently, and their survival time is also longer. This research explores a wider and more thorough perspective of long-term cancer survivors’ needs, experiences, and expectations to be achieved.Departamento de Biología Ambiental y Salud Públic

Evaluation of primary care responsiveness by people with mental illness in Spain.

Background: The health system responsiveness is a concept developed by the World Health Organization that measures patients’ expectations for the non-medical care they receive. The aim of this study is to assess primary care responsiveness as seen by people with mental illness and to analyse the factors associated with poor responsiveness. Methods: Cross-sectional descriptive study on 426 people with mental illness who had attended primary care consultations at least once in the previous 12 months. The responsiveness of the health system was determined through the short questionnaire “Multi-country Survey Study on Health and Health Systems Responsiveness”. Differences in responsiveness by sociodemographic characteristics were compared through the Chi-squared test. Logistic regression identified the factors associated with poor responsiveness. Results: Overall responsiveness was measured as good by 77.4% of patients, being this probability higher in the domains: dignity, confidentiality, and communication. The most valued domains by people with mental illness were prompt attention (42.4%), dignity (30.1%), and communication (17%). Only prompt attention scored high importance and poor responsiveness. In patients with an income lower than 900 euros per month and low level of studies, the probability of poor confidentiality responsiveness was multiplied by 3 and 2.7 respectively. Conclusions: People with mental illness perceive good responsiveness from primary care in terms of dignity, confidentiality, and communication. Prompt attention, as the domain of greatest importance and worst valuation, should be prioritised through the implementation of organisational measures in health centres to reduce waiting times, especially in urban areas.post-print968 K

Thrombolisis in acute Myocardial Infarction. Celia Sánchez Manduley Hospital, October-December 2017

Se realizó un estudio descriptivo retrospectivo transversal mediante la revisión de los expedientes clínicos de los 54 pacientes que estuvieron ingresados en el Hospital “Celia Sánchez Manduley” con el diagnóstico de Infarto Agudo del Miocardio (IMA) en el período octubre-diciembre del 2017, para conocer los beneficios más relevantes del tratamiento trombolítico. Se comprobó que los principales factores que retardan el tratamiento trombolítico con eficacia en las enfermedades coronarias (IMA) fueron: la llegada del paciente fuera del tiempo establecido (29,2 %); la hipotensión arterial (9,75 %) y las arritmias (14,6 %); además se observaron signos relevantes de reperfusión y una evolución excelente en los pacientes con óptimo tiempo dolor-aguja (< 2 horas), donde los pacientes trombolizados respondieron favorablemente (23,00 %); mientras que la evolución favorable de los que fueron trombolizados y su tiempo dolor-aguja se comportó al 31,48 %. La información obtenida se procesó en una base de datos mediante el paquete estadístico SPSS 11.5 y se expuso en tablas para su mejor análisis y discusión de los resultados.A descriptive cross sectional, retrospective study was carried out by reviewing the clinical histories of 54 patients who were admitted to Celia Sánchez Manduley hospital with acute Myocardial Infarction diagnosis (AMI) in the period October-December 2017, to know the most relevant benefits of. Thrombolytic treatment with efficacy in coronary diseases were: the arrival of the patient outside the established time (29,2 %); the  arterial hypotension (9,75 %) and the arrhythmias (14,6 %); also relevants signs of  reperfusion were observed and an excellent evolution in patient with optimal pain-needle time (2 hours) where the thrombolyzed patients answered favorably (23,00 %) while the favorable evolution of those who were thrombolyzed and their pain-needle time was behaved to (31,48%). The information was processed in a data by means of statistical package SPSS 11,5 and it was presented in tables for a better analysis and discussion of the results

MULTICAGE CAD-4 para la detección de adicciones conductuales: validez estructural después de la inclusión de una escala en el abuso de teléfonos inteligentes

Addictive behaviors are not limited to drugs use, but also include certain daily behaviors that can cause gratification. Their progression to more severe pathological patterns entails grave consequences for the individual, including multiple psychopathological manifestations. The early detection of this type of behavior is of concern to primary health care. Therefore, in order to detect risk at early stages, reliable and valid tools for daily practice are essential. The MULTICAGE CAD-4 questionnaire is a screening tool for simultaneously detecting addictive behaviors. This study includes a new scale for the detection of smartphone abuse. The objective is to evaluate the adequacy of its psychometric properties. A sample of 2,074 subjects that were recruited from primary care centers ofMadrid(Spain) completed the MULTICAGE CAD-4 questionnaire. A confirmatory factor analysis, using unweighted least squares method, was performed. The test showed good internal consistency both at item and scale levels. The questionnaire structure was consistent with theoretical expectations. The MULTICAGE CAD-4, including the new smartphone scale, is a robust, reliable tool with a valid structure for assessing the presence of dysfunctional or potentially addictive behaviors, and especially useful in primary health care services.Los comportamientos adictivos no se limitan al uso de drogas, sino que también incluyen ciertos comportamientos diarios que pueden causar gratificación. Su progresión a patrones patológicos más severos conlleva graves consecuencias para el individuo, incluidas múltiples manifestaciones psicopatológicas. La detección temprana de este tipo de comportamiento es de interés para la atención primaria de salud. Por lo tanto, para detectar riesgos en etapas tempranas, las herramientas confiables y válidas para la práctica diaria son esenciales. El cuestionario MULTICAGE CAD-4 es una herramienta de detección para detectar simultáneamente conductas adictivas. Este estudio incluye una nueva escala para la detección del abuso de teléfonos inteligentes. El objetivo es evaluar la adecuación de sus propiedades psicométricas. Una muestra de 2.074 sujetos reclutados en centros de atención primaria de Madrid (España) completó el cuestionario MULTICAGE CAD-4. Se realizó un análisis factorial confirmatorio, utilizando el método de mínimos cuadrados no ponderados. La prueba mostró una buena consistencia interna tanto a nivel del ítem como de las escalas. La estructura del cuestionario fue consistente con las expectativas teóricas. El MULTICAGE CAD-4, incluida la nueva escala para teléfonos inteligentes, es una herramienta robusta y confiable con una estructura válida para evaluar la presencia de comportamientos disfuncionales o potencialmente adictivos, y especialmente útil en servicios de atención primaria de salud

((R)-( )-3-Hydroxyquinuclidium)[FeCl4]; a plastic hybrid compound with chirality, ferroelectricity and long range magnetic ordering

Quinuclidinium salts and their derivatives are now in the focus of materials science as building units of multifunctional materials. Their properties can be easily switchable, allowing their use in a wide range of physical applications. One type of these kinds of materials, the homochiral hybrid halometallate ferroelectric compounds, is not well understood. In this work, (R)-( )-3-quinuclidinol hydrochloride was used in the synthesis of ((R)-( )-3-hydroxyquinuclidium)[FeCl4]. The use of this enantiomeric cation forces crystallographic non-centrosymmetry, which was confirmed by polarimetry and circular dichroism spectroscopy. We studied the physical properties of this compound at different temperatures by single crystal, synchrotron and neutron powder X-ray diffraction, which showed a rich series of structural and magnetic phase transitions. From synchrotron powder X-ray diffraction data, a plastic phase was observed above 370 K (phase I). Between 370 K and ca. 310 K, an intermediate polar phase was detected, solved in a non-centrosymmetric polar space group (C2) (phase II). Below ca. 310 K, the compound crystallizes in the triclinic P1 non-centrosymmetric space group (phase III) which is maintained down to 4 K, followed by phase IV, which shows tridimensional magnetic ordering. The temperature evolution of the neutron diffraction data shows the appearance of new reflections below 4 K. These reflections can be indexed to a commensurate propagation vector k = (0, 0, 12). The magnetic structure below TN was solved in the Ps1 Shubnikov space group, which gives rise to an antiferromagnetic structure, compatible with the magnetometry measurements. Near room temperature, the crystal phase transition is associated with a dielectric change. In particular, the phase transition between phase III (S.G.:P1) and phase II (S.G.:C2) involves an increase of symmetry between two non-centrosymmetric space groups. Therefore, it allows, by symmetry, the emergence of ferroelectric and ferroelastic ordering. Piezoresponse force microscopy (PFM) imaging measurements provided evidence for polarization switching and a local ferroelectric behavior of phase III at room temperature. Additionally, the obtained butterfly curve and hysteresis loop by PFM exhibits a low coercive voltage of B10 V. This value is remarkable, since it approaches those obtained for materials with application in ferroelectric random access memories (FeRAMs).Financial support from Universidad de Cantabria (Proyecto Puente convocatoria 2018 funded by SODERCAN_FEDER), Universidad del País Vasco/Euskal Herriko Unibertsitatea (GIU17/50 and PPG17/37) and Ministerio de Economia y Competividad (MAT2017-89239-C2-(1,2)-P, MAT2017-83631-C3-3-R, MAT2017-86453-R, PGC2018-097520-A-100 and PID2019-104050RAI00) is acknowledged. The authors gratefully acknowledge the technical and human support provided by SGIKer (UPV/EHU, MINECO, GV/EJ, ERDF, and ESF). Carmen Martín is grateful to VI PPIT-2018 from Universidad de Sevilla. The paper is (partly) based on the results of experiments carried out at the ALBA Synchrotron Light Source in Barcelona (proposal 2019083666) and Institute Laue-Langevin (ILL) of Grenoble (Proposals 5-31-2580 and 5-31-2460)

Characterization of retinal drusen in subjects at high genetic risk of developing sporadic Alzheimer’s disease: An exploratory analysis

Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ε4 allele of the ApoE gene are two of the main risk factors for the development of AD. AD and age-related macular degeneration (AMD) share one of the main risk factors, such as age, and characteristics including the presence of deposits (Aβ plaques in AD and drusen in AMD); however, the role of apolipoprotein E isoforms in both pathologies is controversial. We analyzed and characterized retinal drusen by optical coherence tomography (OCT) in subjects, classifying them by their AD FH (FH-or FH+) and their allelic characterization of ApoE ε4 (ApoE ε4-or ApoE ε4+) and considering cardiovascular risk factors (hypercholesterolemia, hypertension, and diabetes mellitus). In addition, we analyzed the choroidal thickness by OCT and the area of the foveal avascular zone with OCTA. We did not find a relationship between a family history of AD or any of the ApoE isoforms and the presence or absence of drusen. Subjects with drusen show choroidal thinning compared to patients without drusen, and thinning could trigger changes in choroidal perfusion that may give rise to the deposits that generate drusen

Lower IgG somatic hypermutation rates during acute dengue virus infection is compatible with a germinal center-independent B cell response

Reads, clonal groups, and lineages numbers per individual and condition. The table shows the number of raw and used sequences as well as the number of clonotypes and lineages per individual. (XLS 30 kb

Add-on inhaled budesonide in the treatment of hospitalised patients with COVID-19 : a randomised clinical trial

SARS-CoV-2 vaccines have been extremely effective to reduce the incidence of severe COVID19 [1-3], but effective and safe treatments of the acute infection are still limited [4, 5]. An uncontrolled pulmonary inflammatory response to SARS-CoV-2 is considered a key pathogenic mechanism of COVID19 progression [6], so systemic dexamethasone is recommended in severe cases [5, 7]. On the other hand, in very mild patients at home inhaled corticosteroids (ICS) may prevent disease progression [8-11]. Whether ICS prevent disease progression too in patients hospitalised because of COVID19 has not been explored before. Accordingly, we designed an investigator-initiated, open-label, randomised clinical trial (RCT) to explore the efficacy of adding inhaled budesonide to usual care to prevent disease progression in patients hospitalised because of COVID19 pneumonia. We also monitored carefully the safety of this intervention since there are concerns about the use of systemic corticosteroids in other viral (influenza) lung infections [12]

Desafíos de las metrópolis: Efectos ambientales y sociales. Tendencias geográficas II

El libro está conformado de estudios realizados por profesores-investigadores de la Universidad Autónoma del Estado de México, de la Universidad de Varsovia, así como de la Universidad Pedagógica Comisión de Educación Nacional de Cracovia. En esta obra se exponen algunas investigaciones sobre los cambios en los factores sociales, naturales, económicos y ambientales como principales desafios que presentan las zonas de México, Polonia y de contextos de Sudamérica, tales como Sao Paulo, Quito y Bogotá y ciudades medias y pequeñas.Universidad Autónoma del Estado de Méxic