Impact of a Community Intervention for Early Skin Cancer Diagnosis Implementing Teledermatology

The principal cause of skin cancer is sun exposure. In areas with high sun exposure levels, early diagnosis and sun protection education strategies must be developed. Aim of the study was to evaluate the impact of an early skin cancer diagnosis intervention implementing teledermatology. Transversal descriptive study on a population in the Western Costa del Sol. Primary care physicians were instructed on skin cancer diagnosis. They recruited consecutive at-risk patients and held four workshops for early skin cancer diagnosis and education on sun protection. The resulting variables on participants’ satisfaction and intention to change were collected. 393 patients were recruited. The mean age was 52.9 years, and 65.4% were women. Suspicious lesions were detected in 24.1% of participants, and 11.7% were attended to via teledermatology. Of these, 65.2% were evaluated in person at the Dermatology Department. Fourteen basal cell carcinomas, 5 squamous cell carcinomas, and 2 melanomas were diagnosed. Regarding patient satisfaction, 67.7% found all aspects of the workshops of interest, 41.7% found the skin check-up of interest, and 26.4% found sun and skin cancer prevention information of interest. Of the patients attended to via teledermatology, 100% stated it was good or very good and 100% would consult again via this method. The intervention was successful in terms of participation, skin cancer diagnosis, and satisfaction, especially compared with other international campaigns. Therefore, although the data cannot be extrapolated to all environments, this initiative may be used as the basis for the development of future interventions

Impact of a Community Intervention for Early Skin Cancer Diagnosis Implementing Teledermatology

The principal cause of skin cancer is sun exposure. In areas with high sun exposure levels, early diagnosis and sun protection education strategies must be developed. Aim of the study was to evaluate the impact of an early skin cancer diagnosis intervention implementing teledermatology. Transversal descriptive study on a population in the Western Costa del Sol. Primary care physicians were instructed on skin cancer diagnosis. They recruited consecutive at-risk patients and held four workshops for early skin cancer diagnosis and education on sun protection. The resulting variables on participants’ satisfaction and intention to change were collected. 393 patients were recruited. The mean age was 52.9 years, and 65.4% were women. Suspicious lesions were detected in 24.1% of participants, and 11.7% were attended to via teledermatology. Of these, 65.2% were evaluated in person at the Dermatology Department. Fourteen basal cell carcinomas, 5 squamous cell carcinomas, and 2 melanomas were diagnosed. Regarding patient satisfaction, 67.7% found all aspects of the workshops of interest, 41.7% found the skin check-up of interest, and 26.4% found sun and skin cancer prevention information of interest. Of the patients attended to via teledermatology, 100% stated it was good or very good and 100% would consult again via this method. The intervention was successful in terms of participation, skin cancer diagnosis, and satisfaction, especially compared with other international campaigns. Therefore, although the data cannot be extrapolated to all environments, this initiative may be used as the basis for the development of future interventions

KHK, PNPLA3 and PPAR as Novel Targets for the Anti-Steatotic Action of Bempedoic Acid

Bempedoic acid (BemA) is an ATP-citrate lyase (ACLY) inhibitor used to treat hypercholesterolemia. We studied the anti-steatotic effect of BemA, and the mechanisms involved, in a model of fatty liver in female rats obtained through the administration of a high-fat diet supplemented with liquid fructose (HFHFr) for three months. In the third month, a group of rats was treated with BemA (30 mg/kg/day) by gavage. Plasma analytes, liver histology, adiposity, and the expression of key genes controlling fatty acid metabolism were determined, and PPAR agonism was explored by using luciferase reporter assays. Our results showed that, compared to HFHFr, BemA-treated rats exhibited lower body weight, higher liver/body weight, and reduced hepatic steatosis. In addition to ACLY inhibition, we found three novel mechanisms that could account for the anti-steatotic effect: (1) reduction of liver ketohexokinase, leading to lower fructose intake and reduced de novo lipogenesis; (2) increased expression of patatin-like phospholipase domain-containing protein 3, a protein related to the export of liver triglycerides to blood; and (3) PPARα agonist activity, leading to increased hepatic fatty acid β-oxidation. In conclusion, BemA may represent a novel approach to treat hepatic steatosis, and therefore to avoid progression to advanced stages of non-alcoholic fatty liver disease

El cambio conceptual de dos maestras en relación con la enseñanza y el aprendizaje de la lengua oral a través de un asesoramiento: un estudio de casos

Resumen En este trabajo presentamos los resultados de una investigación en la que han participado 4 maestras: 2 de educación infantil y 2 de educación primaria. Se ha llevado a cabo un asesoramiento utilizando la metodología conversacional a una maestra de cada nivel educativo con el objetivo de promover un cambio conceptual en relación con la representación sobre los procesos de enseñanza y aprendizaje de la lengua oral. Durante un periodo de 4 meses las 2 maestras del grupo experimental participaron en 4 reuniones de asesoramiento con algunos de los investigadores. Además se realizó un grupo de discusión con las 2 maestras del grupo experimental y del grupo control antes del asesoramiento y otro una vez finalizado este. Se elaboró un instrumento ad hoc para analizar las reuniones de asesoramiento y los grupos de discusión. Los resultados indican que las maestras del grupo experimental progresan desde una visión de la lengua oral centrada en aspectos de forma y contenido, y desde la consideración de los factores madurativos como principales responsables del aprendizaje de la lengua oral, hacia una conceptualización que otorga una importancia fundamental a los aspectos de uso del lenguaje, a la interacción social y a las estrategias que utilizan las maestras en clase como factores explicativos de la competencia oral de los alumnos. Abstract We present the results of a research project in which 4 teachers (2 kindergarten and 2 primary school teachers) took part. A counselling process using conversational methodology was carried out with one teacher from each setting to promote a conceptual change in the teachers' representation of oral language teaching and learning processes. During a 4-month period, the 2 teachers in the experimental group participated in 2 counselling meetings with some of the researchers. We also carried out a focus group with all four teachers before and after the meetings. An ad hoc instrument was designed to analyze the meetings and the focus groups. The results show that teachers in the experimental group progressed from a conception focused on formal and content-based aspects of oral language to a conception that stresses language use, social interaction, and the strategies employed by teachers in class as explanatory factors for pupils' oral language competence

Development and characterization of functional O/W emulsions with chia seed (<i>Salvia hispanica</i> L.) by-products

The present work investigated the physicochemical properties of O/W emulsions containing functional ingredients (oil with high x-3 fatty acid content, protein and/or soluble fiber) from chia seeds. The effect of different protein–carbohydrate combinations (sodium caseinate and lactose, sodium caseinate and maltodextrin, chia protein-rich fraction and maltodextrin) and the presence of chia mucilage (0 and 0.2 % wt/wt) in the aqueous phase of chia O/W emulsions was studied as a function of droplet size distribution, Sauter mean diameter, f-potential, rheological properties and backscattering profiles. The use of sodium caseinate in combination with lactose or maltodextrin produced chia O/W emulsions with small droplet size (0.22–0.27 lm), high degree of uniformity in droplet size distribution, negatively charged droplets (at pH 6.5), pseudoplastic behavior and high physical stability. Emulsions with chia protein-rich fraction presented wider droplet size distribution and higher D[3,2] values than the previous ones, recording a Newtonian behavior. The addition of chia mucilage affected the physicochemical properties studied, mainly the rheological characteristics of emulsions.Centro de Investigación y Desarrollo en Criotecnología de AlimentosCentro de Tecnología de Recursos Minerales y Cerámic

Evaluación del riesgo cardiovascular global en población adulta del Consultorio Médico 21

Myocardial ischemia is internationally one of the first causes of death, and to value the quantitative risk of suffering it have been created charts of risk, one of those more employed have been the charts approved by the World Organization of the Health. With the objective of evaluating the cardiovascular global risk in the population in the health area 21 from the University Policlinic Jimmy Hirzel, it was performed a quantitative, prospective and descriptive study, with analytic phases, in a universe of 937 patients made from November 1st from the 2015 to June 29, 2017. Feminine sex prevailed (53.68 %) and the half age was of 56.6 years in a 35-74-year-old range. The 9.39 % of the patients suffered diabetes mellitus, 79.94 % practiced tobacco smoking, 32.6 % of the patients was overweight, a prevalence of the interval was observed from 131-140 mmHg of systolic arterial pressure with a mean of 145.23 mmHg. According to the AMR-A charts, in the context where you cannot measure serum cholesterol, and those of Gaziano, the evaluation of the risk located to 46 % and 47.71% the population's in a moderate level of risk, respectively. According to chi square tests are accepted indistinctly for the estimate of the global cardiovascular risk.La cardiopatía isquémica es una de las primeras causas de muerte internacionalmente, y para valorar el riesgo cuantitativo de padecerla se han creado tablas de riesgo; una de las más empleadas son las tablas aprobadas por la Organización Mundial de la Salud. Con el objetivo de evaluar el riesgo cardiovascular global en la población del área de salud 21 de la Policlínica Universitaria Jimmy Hirzel, se realizó un estudio cuantitativo, prospectivo y descriptivo, con fases analíticas, en un universo de 937 pacientes desde el 1º de noviembre del 2015 al 29 de junio del 2017. Predominó el sexo femenino (53.68 %) y la edad media fue de 56.6 años en un rango de 35-74 años. El 9.39 % de los pacientes padecía diabetes mellitus, el 79.94 % practicaban el tabaquismo, el 32.6 % de los pacientes eran sobrepeso, se observó una prevalencia del intervalo comprendido entre los 131–140 mmHg de presión arterial sistólica con una media de 145.23 mmHg. Según las tablas AMR-A, en el contexto donde no se puede medir el colesterol sérico y las de Gaziano, la evaluación del riesgo ubicó al 46 % y 47.71 % de la población en un nivel moderado de riesgo, respectivamente. Según el estadígrafo de chi cuadrado ambas pruebas se aceptan indistintamente para la estimación del riesgo cardiovascular global

Role of asymptomatic bacteriuria on early periprosthetic joint infection after hip hemiarthroplasty. BARIFER randomized clinical trial

[Purpose] To evaluate preoperative asymptomatic bacteriuria (ASB) treatment to reduce early-periprosthetic joint infections (early-PJIs) after hip hemiarthroplasty (HHA) for fracture.[Methods] Open-label, multicenter RCT comparing fosfomycin-trometamol versus no intervention with a parallel follow-up cohort without ASB. Primary outcome: early-PJI after HHA.[Results] Five hundred ninety-four patients enrolled (mean age 84.3); 152(25%) with ASB (77 treated with fosfomycin-trometamol/75 controls) and 442(75%) without. Despite the study closed without the intended sample size, ASB was not predictive of early-PJI (OR: 1.06 [95%CI: 0.33–3.38]), and its treatment did not modify early-PJI incidence (OR: 1.03 [95%CI: 0.15–7.10]). [Conclusions] Neither preoperative ASB nor its treatment appears to be risk factors of early-PJI after HHA. ClinicalTrials.gov Identifier: Eudra CT 2016-001108-47.This work was supported by the Spanish Clinical Research Network (SCReN), co-finaced by the ISCIII-Subdirección General de Evaluación y Fomento de la Investigación, through the project PI15/02161 and by the Plan Nacional de I+D+i 2013-016 and ISCIIII, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Economia, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0003)-co-financed by European Development Regional Fund “A way to achieve Europe,” Operative program Intelligent Growth 2014-2020.Peer reviewe

INCERTEZA E QUALIDADE DE VIDA EM HOMENS E MULHERES ACOMETIDAS PELO CÂNCER.

This descriptive study was intended to determine the association between uncertainty in the quality of life in men and women of breast cancer and prostate in the city of Puebla, Mexico. A transversal and correlational design was used. Data collection was carried out with two scales: Uncertainty in illnes (MUIS C) and assessment subjective of the quality of life (ESCV). Responded to the survey a total of 100 people; the analysis of the data revealed levels of uncertainty in an averageof 48.59 (DE = 15.7, range = 16 to 87); and to the levels of quality of life, an average of 58.25 (DE = 19.5, range = 15 to 100). The uncertainty was positively correlated to the quality of life (r = 0.248, p = 0.13); for domains of uncertainty: the ambiguity had, an average of 43.58 (DE = 18.6, range = 0-88); the level of complexity obtained an average of 59.6. x (of = 20.4, range = 5 to 100); lackof information reached an average of 45.0 (DE = 18.4, range = 3.5 to 85) and for theunpredictability an average of 61.5 (DE = 23.4, range = 7 to 80). Reconceptualising of uncertainty in illnes theory and its development prospectscan explain the relationship between uncertainty and the quality of life in men and women survivors of cancer and can serve as a guide for future studies.Este estudio descriptivo tuvo el propósito de conocer la asociación entre la incertidumbre en la calidad de vida en hombres y mujeres de cáncer de mama y próstata en la ciudad de Puebla, México. Se utilizó un diseño transversal y correlacional. La recolección de datos se llevó a cabo con dos escalas: incertidumbre frente a la enfermedad (MUIS C) y la Evaluación Subjetiva de laCalidad de Vida (ESCV). Respondieron la encuesta un total de 100 personas; el análisis de los datos reveló niveles de incertidumbre en una media de 48.59 (DE =15.7, rango = 16 a 87); y para los niveles de calidad de vida, una media de 58.25 (DE = 19,5, rango = 15 a 100). La incertidumbre se correlacionó positivamente a la calidad de vida (r = 0.248, p = 0.13); para los dominios de incertidumbre: la ambigüedad tuvo, una media de 43.58 (DE = 18.6, rango = 0 a 88); el nivel de complejidad obtuvo una media de 59.6.x (DE = 20.4, rango = 5 a 100);la falta de información alcanzó una media de 45.0 (DE = 18.4, rango = 3.5 a 85) y para la falta de predicción una media de 61.5 (DE = 23.4, rango = 7 a 80). La conceptualización de la teoría de incertidumbre ante la enfermedad y las perspectivas de su desarrollo pueden explicar las relaciones entre la incertidumbre y la calidad de vida en hombres y mujeres sobrevivientes de cáncer y pueden servir como guía para estudios futuros.Este estudo descritivo foi destinado a determinar a associação entre incerteza na qualidade de vida em homens e mulheres de câncer de mama e de próstata na cidade de Puebla, México. Utilizou-se um projeto transversal e busca. Coleta de dados foi realizada com duas escalas: a incerteza sobre a doença (MUIS C) e avaliação subjetiva da qualidade de vida (ESCV). Respondeu à pesquisa um total de 100 pessoas; a análise dos dados revelou níveis de incerteza em uma média de 48.59 (DE = 15,7, gama = 16 a 87); e os níveis de qualidade de vida, uma média de 58.25 (DE = 19,5, gama = 15 a 100). A incerteza foi positivamente correlacionada com a qualidade de vida (r = 0,248, p = 0,13); para domínios de incerteza: a ambigüidade tinha, uma média de 43.58 (DE = 18,6, escala = 0-88); o nível de complexidade obteve uma média de 59,6. x (de = 20,4, gama = 5 a 100); falta de informação atingiu uma média de 45.0 (DE = 18,4, gama = 3.5 a 85) e pela falta de previsão média de 61,5 (DE = 23,4, gama = 7 a 80). Reconceptualising de incerteza antes da teoria de doença e de suas perspectivas de desenvolvimento podem explicar a relação entre a incerteza e a qualidade de vida em homens e mulheres sobreviventes de câncer e podem servir como um guia para futuros estudos

Factors related with symptom duration until diagnosis and treatment of symptomatic colorectal cancer

BACKGROUND: Colorectal cancer (CRC) survival depends mostly on stage at the time of diagnosis. However, symptom duration at diagnosis or treatment have also been considered as predictors of stage and survival. This study was designed to: 1) establish the distinct time-symptom duration intervals; 2) identify factors associated with symptom duration until diagnosis and treatment. METHODS: This is a cross-sectional study of all incident cases of symptomatic CRC during 2006–2009 (795 incident cases) in 5 Spanish regions. Data were obtained from patients’ interviews and reviews of primary care and hospital clinical records. Measurements: CRC symptoms, symptom perception, trust in the general practitioner (GP), primary care and hospital examinations/visits before diagnosis, type of referral and tumor characteristics at diagnosis. Symptom Diagnosis Interval (SDI) was calculated as time from first CRC symptoms to date of diagnosis. Symptom Treatment Interval (STI) was defined as time from first CRC symptoms until start of treatment. Nonparametric tests were used to compare SDI and STI according to different variables. RESULTS: Symptom to diagnosis interval for CRC was 128 days and symptom treatment interval was 155. No statistically significant differences were observed between colon and rectum cancers. Women experienced longer intervals than men. Symptom presentation such as vomiting or abdominal pain and the presence of obstruction led to shorter diagnostic or treatment intervals. Time elapsed was also shorter in those patients that perceived their first symptom/s as serious, disclosed it to their acquaintances, contacted emergencies services or had trust in their GPs. Primary care and hospital doctor examinations and investigations appeared to be related to time elapsed to diagnosis or treatment. CONCLUSIONS: Results show that gender, symptom perception and help-seeking behaviour are the main patient factors related to interval duration. Health service performance also has a very important role in symptom to diagnosis and treatment interval. If time to diagnosis is to be reduced, interventions and guidelines must be developed to ensure appropriate examination and diagnosis during both primary and hospital care

Factors related with symptom duration until diagnosis and treatment of symptomatic colorectal cancer

[Abstract] Background: Colorectal cancer (CRC) survival depends mostly on stage at the time of diagnosis. However, symptom duration at diagnosis or treatment have also been considered as predictors of stage and survival. This study was designed to: 1) establish the distinct time-symptom duration intervals; 2) identify factors associated with symptom duration until diagnosis and treatment. Methods: This is a cross-sectional study of all incident cases of symptomatic CRC during 2006-2009 (795 incident cases) in 5 Spanish regions. Data were obtained from patients' interviews and reviews of primary care and hospital clinical records. Measurements: CRC symptoms, symptom perception, trust in the general practitioner (GP), primary care and hospital examinations/visits before diagnosis, type of referral and tumor characteristics at diagnosis. Symptom Diagnosis Interval (SDI) was calculated as time from first CRC symptoms to date of diagnosis. Symptom Treatment Interval (STI) was defined as time from first CRC symptoms until start of treatment. Nonparametric tests were used to compare SDI and STI according to different variables. Results: Symptom to diagnosis interval for CRC was 128 days and symptom treatment interval was 155. No statistically significant differences were observed between colon and rectum cancers. Women experienced longer intervals than men. Symptom presentation such as vomiting or abdominal pain and the presence of obstruction led to shorter diagnostic or treatment intervals. Time elapsed was also shorter in those patients that perceived their first symptom/s as serious, disclosed it to their acquaintances, contacted emergencies services or had trust in their GPs. Primary care and hospital doctor examinations and investigations appeared to be related to time elapsed to diagnosis or treatment. Conclusions: Results show that gender, symptom perception and help-seeking behaviour are the main patient factors related to interval duration. Health service performance also has a very important role in symptom to diagnosis and treatment interval. If time to diagnosis is to be reduced, interventions and guidelines must be developed to ensure appropriate examination and diagnosis during both primary and hospital care.Instituto de Salud Carlos III; PI:052273Instituto de Salud Carlos III; PI050787Instituto de Salud Carlos III; PI050700Instituto de Salud Carlos III; PI052692Instituto de Salud Carlos III; PI05214