Gastrointestinal Stromal Tumor (GIST) and its relationship with germline mutations

We present the case of a 38-year-old man with a history of abdominal paraganglioma 10 years ago, who consulted for hematemesis and asthenia of 5 days' evolution. An upper gastrointestinal endoscopy was performed where a raised submucosal lesion, about 2 cm, with ulceration on its surface, was observed at the corporal-antral junction. The CT scan revealed nodular thickening of the gastric wall at the level of the lesser curvature. After the resolution of his hematemesis, it was decided to intervene on the patient, performing a partial gastrectomyUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

D1.2 Handbook of multi-hazard, multi-risk definitions and concepts

This report is the first output of Work Package 1: Diagnosis of the MYRIAD-EU project: Handbook of Multi-hazard, Multi-Risk Definitions and Concepts. The aim of the task was to (i) acknowledge the differences and promote consistency in understanding across subsequent work packages in the MYRIAD-EU project, (ii) improve the accessibility of our work to a broad array of stakeholders and (iii) strengthen consensus across the hazard and risk community through a common understanding of multi-hazard, multi-risk terminology and concepts. The work encompassed a mixed-methods approach, including internal consultations and data-generating exercises; literature reviews; external stakeholder engagement; adopting and building on a rich existing body of established glossaries. 140 terms are included in the glossary, 102 related to multi-hazard, multi-risk, disaster risk management and an additional 38 due to their relevance to the project, acknowledging the need for a common understanding amongst an interdisciplinary project consortium. We also include extended definitions related to concepts particularly of relevance to this project deliverable, including ‘multi-hazard’, ‘hazard interrelationships’, ‘multi-risk’ and ‘direct and indirect loss and risk’. Underpinned by a literature review and internal consultation, we include a specific section on indicators, how these might be applied within a multi-hazard and multi-risk context, and how existing indicators could be adapted to consider multi-risk management. We emphasise that there are a number of established glossaries that the project (and risk community) should make use of to strengthen the impact of the work we do, noting in our literature review a tendency in papers and reports to define words afresh. We conclude the report with a selection of key observations, including terminology matters – for all aspects of disaster risk management, for example communication, data collection, measuring progress and reporting against Sendai Framework targets. At the same time, we discuss when is it helpful to include ‘multi-‘ as a prefix, questioning whether part of the paradigm shift needed to successfully address complex challenges facing an interconnected world is through inherently seeing vulnerability, exposure and disaster risk through the lens of multiple, interrelated hazards. We emphasise that there is likely to be an evolution of the terminology throughout the project lifetime as terms are emerge or shift as the project evolves. Finally, we propose a roadmap for developing and testing draft multi-risk indicators in MYRIAD-EU. The WP1 team would like to acknowledge all the contributions of the consortium on this task and the feedback from the External Advisory Board, in particular the chair of the board Virginia Murray, Head of Global Disaster Risk Reduction at the UK Health Security Agency, and the contribution of Jenty Kirsch-Wood, Head of Global Risk Management and Reporting at UNDRR, for her reflections on the findings of this work

Casos clínics d'infeccions del tracte urinari

Aquesta activitat va començar amb el Projecte d’Innovació Docent 2012PID-UB/137 «Aprenentatge de la Microbiologia clínica mitjançant la redacció i resolució de casos clínics», Assignatura Microbiologia i Parasitologia, Facultat de Farmàcia, Universitat de Barcelona. Curs:2012-2013, Tutores: Núria Rius Bofill i Ana M. Marqués VillavecchiaLa monografia que presentem a continuació, és un compendi de casos clínics sobre infeccions del tracte urinari redactats per estudiants de l’assignatura Microbiologia i Parasitologia clíniques, obligatòria de la menció Farmàcia assistencial i anàlisi clíniques del grau de Farmàcia. Els casos clínics proposats consten d’una primera part amb l’enunciat del cas i una sèrie de preguntes relacionades amb el diagnòstic microbiològic de la infecció, i una segona part que consisteix en la discussió de les respostes a les preguntes plantejades. El text és bilingüe, català i castellà, respectant la llengua utilitzada per cada alumne a l’hora de redactar el cas pràctic

MADCOVID-CSIC: Research and design of scientific dissemination activities on COVID-19 aimed at the Spanish youth

MADCOVID-CSIC is an outreach project aimed at young people concentrating on the most interesting aspects about the pandemic. These ranged from contagion to emotional impact. It is financed by the Recovery Fund and belongs to the Social Forum of the PTI+ Global Health.Objectives: • Disseminate, inform and promote knowledge about the pandemic among young people. • Promote greater awareness of young people about the risks of COVID-19. • Encourage young people to be the link of information and dissemination with their immediate family and friends. • Help young people emotionally manage the pandemic.Methods: First we sent a questionnaire to the teacher in order to determine the topics that interest the most: disease,contagion, vaccine, duration of the pandemic, misinformation, fake news and emotional management. The content of the talks is adapted to priorities. Then, an assessment of the experience is made between speakers and teachers to detect changes in behavior and perception of the pandemic among the students.Results and conclusions: To date, more than 25 talks have been given in educational centers, 11 of them in collaboration with secondary schools associated with the CSIC’s Science dissemination Project “Ciencia en el Barrio”, orientated to socially and vulnerable neighborhood in Madrid and the surrounded metropolitan area. In the talks, emotional management is treated preferentially, through collaboration with a cabinet of psychologists that is receiving great interest from teachers and students. They learn to recognize and name emotions, normalizing them and discarding emotional garbage, favoring more emotionally proactive, tolerant and healthy attitudes.Peer reviewe

Delaying surgery for patients with a previous SARS-CoV-2 infection

Not availabl