La maternidad biológica compartida en parejas lesbianas. La técnica de fertilización «in vitro» con el método de recepción de ovocitos de la pareja (ROPA): una revisión de la literatura

Objetivo: Identificar los aspectos clínicos, éticos y legales de la fertilización in vitro (FIV) con el método de recepción de ovocitos de la pareja (ROPA). Método: Se realizaron búsquedas bibliográficas de publicaciones desde 2009 en las bases de datos CINAHL, Medline, Scopus y PsycINFO. Una primera búsqueda inicial se centró en «técnicas de reproducción asistida» y «homosexualidad» como conceptos amplios. Posteriormente, una segunda búsqueda se centró en «lesbianas» y «método ROPA» específicamente. Resultados: Se incluyeron 11 artículos. Se identificaron 4 áreas temáticas: 1) búsqueda del vínculo biológico compartido en la maternidad de las parejas lesbianas; 2) riesgos relacionados con el tratamiento de FIV con ROPA; 3) consideraciones éticas y aceptabilidad médica de dicha técnica, y 4) marco legal y jurídico actual en España de la FIV con ROPA. Conclusiones: La novedad de la técnica FIV con ROPA no está en los componentes del procedimiento, sino en la experiencia reproductiva compartida, en los riesgos médicos que puede acarrear y en las cuestiones éticas que plantea. Los profesionales de la salud deberían conocer estos aspectos para poder ofrecer una adecuada atención a estas parejas

Contents of the Sexual and Reproductive Health Subject in the Undergraduate Nursing Curricula of Spanish Universities: A Cross-Sectional Study

Background: Nursing students must receive adequate training in Sexual and Reproductive Health (SRH), which could allow them to acquire sufficient knowledge to solve the future SRH needs of everyone. In this study, the contents of the SRH subject in the undergraduate nursing curricula of 77 Spanish universities were examined to determine what SRH training nursing students are receiving. Methods: The contents of the SRH subject of all the curricula that were available online were reviewed. The distribution of the contents (topics) in the two areas (reproductive health and sexual health) was analyzed, and the prevalence of each topic was established. It was also determined whether there were differences between public (n = 52) and private universities (n = 25). Results: The training of nursing students focuses mainly on the area of Reproductive Health (15 topics). Most of the topics of this area had a prevalence greater than 50%. Although the area of Sexual Health had 14 topics, most of these topics had a low prevalence (<20%), especially in private universities. Conclusions: It was found that there is considerable variation in the distribution and prevalence of SRH topics between universities. The contents of the area of Reproductive Health are usually prevalent in most of the curricula. However, the contents of the area of Sexual Health are minimal in most of the universities. An organizational effort is required to determine and standardize the contents of SRH that nursing students should receive in Spain to avoid inequalities in their training. Guaranteeing homogeneous SRH contents will avoid deficit situations that could affect people's car

Long Non-Coding RNAs As Potential Novel Prognostic Biomarkers in Colorectal Cancer

Colorectal cancer (CRC) is the fourth most common cause of death worldwide. Surgery is usually the first line of treatment for patients with CRC but many tumors with similar histopathological features show significantly different clinical outcomes. The discovery of robust prognostic biomarkers in patients with CRC is imperative to achieve more effective treatment strategies and improve patient's care. Recent progress in next generation sequencing methods and transcriptome analysis has revealed that a much larger part of the genome is transcribed into RNA than previously assumed. Collectively referred to as non-coding RNAs (ncRNAs), some of these RNA molecules such as microRNAs (miRNAs) and long non-coding RNAs (lncRNAs) have been shown to be altered and to play critical roles in tumor biology. This discovery leads to exciting possibilities for personalized cancer diagnosis, and therapy. Many lncRNAs are tissue and cancer-type specific and have already revealed to be useful as prognostic markers. In this review, we focus on recent findings concerning aberrant expression of lncRNAs in CRC tumors and emphasize their prognostic potential in CRC. Further studies focused on the mechanisms of action of lncRNAs will contribute to the development of novel biomarkers for diagnosis and disease progression

Breastfeeding in women who conceived using fertility treatments: a systematic review

Las mujeres sometidas a tratamientos de fertilidad (TF) presentan necesidades de atención médica y procesos de toma de decisiones antes y después del parto que pueden influir sobre los comportamientos de lactancia materna (LM). Esta revisión examinó el efecto de los TF (invasivos como inyección intracitoplasmática y/o fecundación in vitro, y menos invasivos como medicación y/o inseminación intrauterina) sobre el inicio, duración y exclusividad de la LM a partir de los estudios observacionales que compararon algún resultado de LM en función del modo de concepción (TF versus concepción espontánea). El efecto de los TF sobre el inicio, duración y exclusividad de la LM fue pequeño o no significativo y en ocasiones contradictorio. La evidencia es limitada debido al bajo número de artículos incluidos con calidad suficiente. Por ello se recomienda, hasta que se tengan más y mejores estudios al respecto, un apoyo individualizado a cada diada madre-hijo según sus características.Women subjected to fertility treatment present needs requiring medical attention and decision-making processes before and after delivery that might influence their behaviour in maternal breastfeeding. This review examined the effect of fertility treatments on the start, duration and exclusiveness of maternal lactation based on all the observational studies that compared some result of maternal lactation according to the form of conception. Two reviewers extracted the data and evaluated the risk of bias. The effect of fertility treatments on the results of maternal lactation was small or not significant, and on occasions contradictory. The evidence is limited due to the low number of articles of sufficient quality included. For the time being, fertility treatments do not seem to influence the start, duration and exclusiveness of maternal lactation, but until more and better studies are available, individualized support is recommended for each mother-child dyad according to its characteristics

Spanish Version of the Scale 'Eventos Adversos Associados às Práticas de Enfermagem' (EAAPE): Validation in Nursing Students

Healthcare carried out by different health professionals, including nurses, implies the possible appearance of adverse events that affect the safety of the patient and may cause damage to the patient. In clinical practice, it is necessary to have measurement instruments that allow for the evaluation of the presence of these types of events in order to prevent them. This study aims to validate the 'Eventos adversos associados às práticas de enfermagem' (EAAPE) scale in Spanish and evaluate its reliability. The validation was carried out through a cross-sectional study with a sample of 337 nursing students from the University of Valencia recruited during the 2018-19 academic year. An exploratory factor analysis was carried out using principal components and varimax rotation. The factor analysis extracted two factors that explained 32.10% of the total variance. Factor 1 explains 22.19% and refers to the 'adverse results' of clinical practice (29 items), and factor 2 explains 9.62% and refers to 'preventive practices' (24 items). Both factors presented high reliability (Cronbach's alpha 0.902 and 0.905, respectively). The Spanish version of the EAAPE is valid and reliable for measuring the perception of adverse events associated with nursing practice and the presence of prevention measures

Mujer joven con astenia, disnea y muerte súbita

Una mujer joven, sin patología asociada, acude a Urgencias por disnea, rigidez y astenia de reciente aparición. Un año antes había presentado un cuadro similar, que se solucionó de forma ambulatoria. En Urgencias presenta empeoramiento súbito en relación con administración de fármacos. El ecocardiograma practicado de urgencia muestra disfunción ventricular severa, que requiere ingreso en Cuidados intensivos donde la paciente presenta disociación electromecánica y exitus sin haberse llegado a diagnóstico clínico definitivo, por lo que se solicita autopsia.A young woman with no co-morbidities comes to the emergency room with sudden onset- dyspnea, stiffness and asthenia. A year ago she had suffered a similar episode, managed successfully as outpatient. In the emergency room she presents sudden deterioration related to drug administration. The echocardiogram finds severe left ventricular dysfunction. She was referred to intensive care unit, where the patient suffers an episode of electromechanical dissociation that did not respond to prolonged cardiopulmonary resuscitation, and dies. An autopsy is requested because of the lack of definitive clinical diagnosis

Social Vision on Wet Nurses in the [Spanish] Newspaper “La Vanguardia” (1881-1908)

Históricamente ha habido situaciones y momentos en que las madres han delegado el proceso de lactancia en nodrizas. En el siglo XIX las nodrizas fueron representadas en la prensa española reproduciendo los esquemas del modelo social androcéntrico imperante. Se pretende describir y categorizar la visión de la nodriza reflejada en la prensa española mediante el análisis de contenido de las fuentes periodísticas de este período. La conclusión alcanzada han sido que la prensa refleja la importancia social de la nodriza como un elemento normalizado en la sociedad con un papel fundamental en los aspectos demográficos de la sociedad, estableciendo una visión dual en función del grupo social al que pertenece el niño/a alimentado y se destaca la visión negativa de las nodrizas por la clase médica, que en el proceso de medicalización de los procesos biológicos, las convierte en objeto de sus críticas y monopoliza el proceso de contratación y selección.Historically, there have been situations and times when mothers have delegated the breastfeeding process to wet nurses. In the 1 9th century, wet nurses were represented in the Spanish press reproducing the schemas of the prevailing androcentric social model. We intend to describe and categorize the view of wet nurses as reflected by the Spanish press through the content analysis of the journalistic sources of this period. The conclusions reached show that press reflects the social importance of wet nurse as a social standard element with an essential role in the demographic aspects of society, establishing a dual vision according to the social group the breastfed child belongs to and emphasizing the negative view of wet nurses by doctors, who, during the medicalization of biological processes, address their critics on wet nurses and monopolize their recruitment and selection

Visión social de las nodrizas en el periódico 'La Vanguardia' (1881 -1908)

Históricamente ha habido situaciones y momentos en que las madres han delegado el proceso de lactancia en nodrizas. En el siglo XIX las nodrizas fueron representadas en la prensa española reproduciendo los esquemas del modelo social androcéntrico imperante. Se pretende describir y categorizar la visión de la nodriza reflejada en la prensa española mediante el análisis de contenido de las fuentes periodísticas de este período. La conclusión alcanzada han sido que la prensa refleja la importancia social de la nodriza como un elemento normalizado en la sociedad con un papel fundamental en los aspectos demográficos de la sociedad, estableciendo una visión dual en función del grupo social al que pertenece el niño/a alimentado y se destaca la visión negativa de las nodrizas por la clase médica, que en el proceso de medicalización de los procesos biológicos, las convierte en objeto de sus críticas y monopoliza el proceso de contratación y selecció

Self-Perception of Dependence as an Indicator of Smartphone Addiction¿Establishment of a Cutoff Point in the SPAI-Spain Inventory.

Background: In recent years, the abusive use of the smartphone has reached a situation that could be considered pathological. In this sense, different instruments to assess this problematic use or addiction to the smartphone are used. One of these instruments is the Smartphone Addition Inventory (SPAI), which has been validated in the Spanish language (SPAI-Spain). The main difficulty of these scales is to establish a cut-off point that determines such mobile addiction. On the other hand, self-perception was used in different addictions as a predictor of the problem. Aim: The objective of this study was to establish the cut-off point in the scores of the SPAI-Spain, using as a reference the self-perception of addiction values. Methods: A receiver operating characteristics (ROC) analysis was carried out, establishing as the cut-off point the one that presented a higher value of Youden J, indicative of its sensitivity and specificity. Results: 2958 participants from the university community completed the SPAI-Spain questionnaire. Differences in SPAI-Spain scores were found among age groups and gender, even though not all of them were statistically significant. When using the self-perception of smartphone addiction as the benchmark value, a score of 44 was established as the cutting point of the SPAI-Spain questionnaire, with a Youden J corresponding to 0.416. Conclusions: The implementation of a cut-off point of the SPAI-Spain questionnaire makes it an instrument that allows early identification of those individuals at risk of addiction, as well as the establishment of preventive and/or intervention measure

Clinico-pathologic case: male with myocardiopathy and rapidly progressive cardiac failure

Se presenta el caso de un varón de 66 años, sin alergias medicamentosas conocidas. Fumó durante más de 40 años, actualmente exfumador. Sin antecedentes familiares de patología cardíaca- En diciembre de 2011 presenta disnea progresiva a los moderados- mínimos esfuerzos que le obliga a acudir en diversas ocasiones a los servicios de urgencias. Se le diagnostica de neumonía del lóbulo medio del pulmón derecho e inicia tratamiento antibiótico empírico. El paciente acude recientemente a Urgencias por edema en miembros inferiores y aumento de peso. Tras ingresar, la evolución inicial es buena y muestra mejora de la disnea y reducción del edema. Se realiza una prueba específica que proporciona el diagnóstico y se inicia el tratamiento correspondiente. El caso se presenta en el foro de las sesiones clinicopatológicas del Hospital Son EspasesThe case is that of a 66 year old male, with no known drug allergies. He is an ex smoker for over 40 years. He has no family history of heart disease. In December/2011 he present with progressive dyspnea at moderate-small efforts and is admitted several times to the ER. He is diagnosed with right middle lobe pneumonia, and an empiric antibiotic treatment is started. The patient is recently admitted to the ER for increased edema of the lower limbs and weight gain. After admission, the initial evolution is good, showing improvement of his dyspnea and reduction of the edema. An specific test is ordered that provides a diagnosis and treatment is established accordingly. The case is discussed in the context of a clinico-pathologic general session at Hospital Son Espase