15 research outputs found

    Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

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    Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

    Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesis

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    Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.info:eu-repo/semantics/publishedVersio

    Publication among academic staff and students: an analysis from the ethical perspective

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    This article analyzes, from the ethical perspective, the authorship of particles carried out among students and professors and their potential conflicts. After the literature review, it has been found that the Vancouver criteria that should be fulfilled for the attribution of authorship of an article are not popularly known by students and academic staff. Many problems are posed in this area, among which the following are highlighted: ghost writer, honorary author, and incorrect assignment in the order authors should appear. The professor-student relationship brings with it implicit risks that could lead to conflict, against which it is the academician who should be cautious to curtail any ethical fault when assigning the authors. The measures recommended to avoid conflicts of authorship among students and academic staff are: early assignment of the authors, reflection among academicians, education to students/academic staff, and external control conducted by journal editors. Conclusion is that lack of awareness of the criteria of authorship by academicians and students is the principal problem in the attribution of authorships. It is indispensable to improve this knowledge and look after the application of said criteria in practice

    SATISFACCIÓN CON LA EDUCACIÓN RECIBIDA EN UN GRUPO DE MUJERES HISTERECTOMIZADAS

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    El significado de la histerectomía para un grupo de hombres chilenos parejas de histerectomizadas

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    Se objetivó conocer el significado de la histerectomía para un grupo de hombres chilenos, parejas de mujeres histerectomizadas (HPMH). Estudio cualitativo, con entrevistas en profundidad realizadas a 15 hombres, parejas de mujeres histerectomizadas, entre Mayo y Septiembre del 2010, previa aprobación de dos Comités de Ética. Para el análisis de los datos se utilizó la perspectiva fenomenológica descrita por Giorgi, y se realizó el análisis de contenido según Krippendorff. Los criterios de Creswell fueron utilizados para evaluar la credibilidad del análisis y asegurar la validez descriptiva. Emergieron cinco dimensiones que representan aspectos únicos del significado de la histerectomía para los hombres parejas de mujeres histerectomizadas: síntomas, comentarios, atributos del útero, preocupaciones, y cambios en la sexualidad. Educar los hombres parejas de mujeres histerectomizadas es una acción fundamental para apoyar a las mujeres que serán sometidas a una histerectomía, siendo necesaria su incorporación en el plan de cuidados de ellas

    The meaning of hysterectomy for a group of chilean men partners of women who have undergone hysterectomy

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    Se objetivó conocer el significado de la histerectomía para un grupo de hombres chilenos, parejas de mujeres histerectomizadas (HPMH). Estudio cualitativo, con entrevistas en profundidad realizadas a 15 hombres, parejas de mujeres histerectomizadas, entre Mayo y Septiembre del 2010, previa aprobación de dos Comités de Ética. Para el análisis de los datos se utilizó la perspectiva fenomenológica descrita por Giorgi, y se realizó el análisis de contenido según Krippendorff. Los criterios de Creswell fueron utilizados para evaluar la credibilidad del análisis y asegurar la validez descriptiva. Emergieron cinco dimensiones que representan aspectos únicos del significado de la histerectomía para los hombres parejas de mujeres histerectomizadas: síntomas, comentarios, atributos del útero, preocupaciones, y cambios en la sexualidad. Educar los hombres parejas de mujeres histerectomizadas es una acción fundamental para apoyar a las mujeres que serán sometidas a una histerectomía, siendo necesaria su incorporación en el plan de cuidados de ellas.The objective of this study was to understand the meaning of hysterectomy according to a group of Chilean men, partners of women who have undergone the procedure (MPWH). This qualitative study was performed with in-depth interviews. A total of 15 men, partners of women who have undergone hysterectomy, were interviewed between May and September of 2010, under the approval of the Ethics Committees. Data analysis was performed using the phenomenological perspective proposed by Giorgi, and content analysis was performed according to Krippendorff. The Crestwell criteria were used to evaluate the trustworthiness of the analysis and guarantee descriptive validity. Five dimensions emerged, which represented unique aspects of hysterectomy according to the men: symptoms, comments, the attributions of the uterus, concerns and changes in sexuality. It is essential to educate MPWH in terms of the support required by women undergoing hysterectomy. Therefore they should be included in the care plan designed for women undergoing hysterectomy.O objetivo deste estudo foi conhecer o significado da histerectomia para um grupo de homens chilenos, parceiros de mulheres histerectomizadas (HPMH). A pesquisa qualitativa foi realizada com entrevistas em profundidade, realizada com um total de quinze homens parceiros de mulheres histerectomizadas, entre maio e setembro de 2010, com aprovação prévia dos Comitês de Ética. Para a análise dos dados foi utilizada a perspectiva fenomenológica descrita por Giorgi e realizada a análise de conteúdo de acordo com Krippendorff. Os critérios de Crestwell foram utilizados para avaliar a credibilidade da análise e garantir a validez descritiva. Surgiram cinco dimensões que representam aspectos únicos do significado da extração do útero para os homens parceiros de mulheres histerectomizadas: sintomas, comentários, atribuições do útero, preocupações e mudanças na sexualidade. Educar os homens parceiros de mulheres histerectomizadas é fundamental para apoiar as mulheres que serão submetidas a uma histerectomia, sendo necessário incorporá-los no plano de cuidados das mulheres histerectomizadas

    Formación de recursos humanos

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    An&aacute;lisis de evaluaci&oacute;n desempe&ntilde;o como gesti&oacute;n RR.HH. y proceso organizacional, Ministerio de Catamarca, 2008-2009&nbsp;An&aacute;lisis de situaci&oacute;n de salud, experiencia de formaci&oacute;n para la gerencia en salud&nbsp;Educaci&oacute;n recibida por un grupo de mujeres histerectomizadas: realidad y sugerencias&nbsp;Equipo de salud de la familia y construcci&oacute;n de v&iacute;nculo: Percepciones de estudiantes de enfermer&iacute;a&nbsp;Formando formadores en salud p&uacute;blica: An&aacute;lisis de las competencias aprendidas en la Regi&oacute;n Metropolitana&nbsp;Perfil sociodemogr&aacute;fico y patolog&iacute;as de la poblaci&oacute;n atendida por internos de medicina durante internado rura
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