49 research outputs found
Effect of oral anticoagulants on the outcome of faecal immunochemical test
Background: We aimed to evaluate whether oral anticoagulants (OACs) alter faecal immunochemical test (FIT) performance in average-risk colorectal cancer (CRC) screening. Methods: Individuals aged 50-69 years were invited to receive one FIT sample (cutoff 75 ng ml-1) between November 2008 and June 2011. Results: Faecal immunochemical test was positive in 9.3% (21 out of 224) of users of OAC and 6.2% (365 out of 5821) of non-users (P-trend Œ 0.07). The positive predictive value (PPV) for advanced neoplasia (AN) in non-users was 50.4% vs 47.6% in users (odds ratio, 0.70; 95% CI, 0.3-1.8; P Œ 0.5). The PPV for AN in OAC more antiplatelets (aspirin or clopidogrel) was 75% (odds ratio, 2; 95% CI, 0.4-10.8; P Œ 0.4). Conclusions: Oral anticoagulant did not significantly modify the PPV for AN in this population-based colorectal screening program. The detection rate of advanced adenoma was higher in the combination OAC more antiplatelets
Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections
IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections
Informe: Derecho del trabajo y de la seguridad social en España en 2013. Algunos puntos crĂticos
Este documento intenta reflejar algunos de los principales cambios y novedades del ordenamiento laboral español en 2013, levantando acta de cĂłmo la mutabilidad de nuestro Derecho del Trabajo es imparable. Este informe, consciente de ello, ofrece una selecciĂłn de elementos esenciales, a juicio de sus autores, especialistas en cada una de las materias, encuadrados en la SecciĂłn Juvenil de la AsociaciĂłn Española de Derecho del Trabajo y de la Seguridad Social. En Ă©l, conforme a la organizaciĂłn de dicha SecciĂłn en grupos de trabajo, se abordan las novedades mĂĄs relevantes en materia de derechos fundamentales inespecĂficos, contrataciĂłn laboral, vicisitudes del contrato de trabajo, Derecho colectivo, conciliaciĂłn y corresponsabilidad, protecciĂłn social y prevenciĂłn de riesgos laborales.
This paper tries to show some of the many changes and novelties in Spanish Labour Law during 2013, drawing up a record of the unstoppable character of our Labour legal system. This report offers a selection of essential elements, according to its authors, all of them specialists in each one of the subjects, being part of the Young Scholarsâ Section of the Spanish Association for Labour and Social Security Law. According to the organization of the said Section in working groups, we can find novelties concerning unspecific fundamental rights, work contracts, the life of the work contract and collective Labour Law, reconciliation and co responsibility, social protection and occupational risk prevention
Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic
This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic
El derecho del trabajo y de la seguridad social en España en 2014
Este documento intenta reflejar algunos de los principales cambios y novedades del ordenamiento laboral español en 2014, levantando acta de cĂłmo la mutabilidad de nuestro Derecho del Trabajo es imparable. Este informe, consciente de ello, ofrece una selecciĂłn de elementos esenciales, a juicio de sus autores, especialistas en cada una de las materias, encuadrados en la SecciĂłn Juvenil de la AsociaciĂłn Española de Derecho del Trabajo y de la Seguridad Social. En Ă©l, conforme a la organizaciĂłn de dicha SecciĂłn en grupos de trabajo, se abordan las novedades mĂĄs relevantes en materia de derechos fundamentales inespecĂficos, contrataciĂłn laboral, vicisitudes del contrato de trabajo, Derecho colectivo, conciliaciĂłn y corresponsabilidad, protecciĂłn social y prevenciĂłn de riesgos laborales.
This paper tries to show some of the many changes and novelties in Spanish Labour Law during 2014, drawing up a record of the unstoppable character of our Labour legal system. This report offers a selection of essential elements, according to its authors, all of them specialists in each one of the subjects, being part of the Young Scholarsâ Section of the Spanish Association for Labour and Social Security Law. According to the organization of the said Section in working groups, we can find novelties concerning unspecific fundamental rights, work contracts, the life of the work contract and collective Labour Law, work-life balance and co responsibility, social protection and occupational risk prevention
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Dietary αâLinolenic Acid, Marine Ïâ3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvenciĂłn con DIeta MEDiterrĂĄnea (PREDIMED) Study
Background: Epidemiological evidence suggests a cardioprotective role of αâlinolenic acid (ALA), a plantâderived Ïâ3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine Ïâ3 fatty acids (longâchain nâ3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to allâcause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for longâchain nâ3 polyunsaturated fatty acids (â„500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvenciĂłn con DIeta MEDiterrĂĄnea (PREDIMED) trial. Multivariableâadjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9ây followâup, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56â0.92) for allâcause mortality and 0.95 (95% CI 0.58â1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for longâchain nâ3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67â1.05) for allâcause mortality, 0.61 (95% CI 0.39â0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29â0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22â1.01) for sudden cardiac death. The highest reduction in allâcause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45â0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to allâcause mortality, whereas protection from cardiac mortality is limited to fishâderived longâchain nâ3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639
How online applications can help to achieve integral learning
The development of transversal competencies provides an integral education. However, its practical implementation among different subjects is not a trivial task. There are several issues that should be previously solved in an optimal way to take advantage of the synergy among subjects. Main issues are: i) the need for a common space for the documents management, ii) the availability of the document everywhere and anytime, and iii) the possibility to collaborate in the documents edition tasks. It was implemented a virtual portfolio for the students which allows the assessment of all the subjects in a global way. To this goal we used the Google apps due to its free access, availability and suitability for the collaborative editing tasks
EvaluaciĂłn de la Licenciatura de Ciencias del Mar en la Universidad de Alicante: una aproximaciĂłn DAFO
La planificaciĂłn de los programas educativos debe basarse y tener en cuenta las necesidades y tendencias de la sociedad. Para ello es necesario someter al proceso educativo a un diagnĂłstico y evaluaciĂłn continuada, con el fin de detectar vacĂos y fallos. El anĂĄlisis DAFO -Debilidades-Amenazas-Fortalezas-Oportunidades- crea un marco de apoyo enfocado a identificar las necesidades de un sistema; en este caso, la sociedad educativa. Esta herramienta estĂĄ diseñada para ser usado en estados preliminares de toma de decisiones o como un precursor de estrategias de planificaciĂłn. En nuestro caso puede suministrar una visiĂłn general de la situaciĂłn en la licenciatura de Ciencias del Mar, en base a un anĂĄlisis interno por parte de los colectivos usuarios directos, ademĂĄs de una comprensiĂłn de los factores externos que permita conseguir una visiĂłn de futuro, con perspectivas a la hora de definir objetivos educativos, diseños programĂĄticos o herramientas docentes eficientes. La experiencia docente obtenida durante los Ășltimos años muestra que los alumnos, a menudo, no encuentran conexiĂłn entre los contenidos de las diferentes materias impartidas en una licenciatura y la extrapolaciĂłn de los conocimientos adquiridos a situaciones reales, con una falta patente de motivaciĂłn y una reducciĂłn en el rendimiento final de los alumnos en cuanto a asimilaciĂłn de contenidos. Los resultados de este anĂĄlisis ayudan a definir programas innovadores e integrados transversalmente, evitando contenidos redundantes e irrelevantes, y permitiendo una coherencia multidisciplinar. Con todo ello se espera mejorar el aprendizaje de contenidos transversales que permitan aprovechar los conocimientos en las materias para su aplicaciĂłn posterior