Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis.

OBJECTIVES: The aim was to study the efficacy and tolerance in patients with haemorrhagic radiation-induced cystitis (HRC) treated with hyperbaric oxygen therapy (HOT) and analyze which factors were related to the response to the treatment. MATERIAL AND METHODS: We performed a retrospective cohort study of patients treated with HOT for HRC symptoms in a provincial referral centre from 2010 to 2020. We evaluated clinical response to treatment, number of hospitalizations due to HRC and subjective response using the PGI-I questionnaire. RESULTS: We treated 52 patients, with a median of 30 sessions, during 6 months and 40 months (6-68 months) of follow-up. 69.2%of patients responded completely and 21,2% partially. The 53.2% of patients improved before the first 10 sessions. Reduction of hospitalizations/per year due to haematuria from 2.8 to 1.1 (p=0,001). The 73,5% of patients stated that they were "very much better" or "much better" after treatment. During the follow-up, 15.4% of patients had recurrence of HRC. 9.6% of the patients required salvage cystectomy. The patients with a highest RTOG-EORTC scale had more risk to still with symptoms (OR 3.01 (IC95 1.48 - 6.16). All patients were able to complete the proposed treatment plan with good tolerance to HOT. CONCLUSIONS: These results show the clinical benefit of HOT in the treatment of HRC, with a reduction of the number of hospitalizations and a subjective improvement.

Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis

Objectives: The aim was to study the efficacy and tolerance in patients with haemorrhagic radiation-induced cystitis (HRC)treated with hyperbaric oxygen therapy (HOT) and analyze which factors were related to the response to the treatment.Material and methods: We performed a retrospective cohort study of patients treated with HOT for HRC symptoms in a provincial referral centre from 2010 to 2020. We evaluated clinical response to treatment, number of hospitalizations due to HRC andsubjective response using the PGI-I questionnaire.Results: We treated 52 patients, with a median of 30 sessions, during 6 months and 40 months (6-68 months) of follow-up. 69.2%of patients responded completely and 21,2% partially. The 53.2% of patients improved before the first 10 sessions. Reduction ofhospitalizations/per year due to haematuria from 2.8 to 1.1 (p=0,001). The 73,5% of patients stated that they were “very muchbetter” or “much better” after treatment. During the follow-up, 15.4% of patients had recurrence of HRC. 9.6% of the patientsrequired salvage cystectomy. The patients with a highest RTOG-EORTC scale had more risk to still with symptoms (OR 3.01(IC95 1.48 – 6.16). All patients were able to complete the proposed treatment plan with good tolerance to HOT.Conclusions: These results show the clinical benefit of HOT in the treatment of HRC, with a reduction of the number of hospitalizations and a subjective improvement. (AU)

Objetivo: conocer eficacia y tolerancia de la hiperoxigemia en cámara hiperbárica (THO) en pacientes con cistitis rádica hemorrágica (CRH) y analizar factores asociadosa respuesta al tratamiento.Material y métodos: estudio de cohorte retrospectivode pacientes tratados mediante THO por CRH en centro dereferencia entre 2010 y 2020. Evaluamos respuesta clínicade la hematuria, número de ingresos hospitalarios por CRHy satisfacción subjetiva mediante cuestionario PGI-I.Resultados: tratamos 52 pacientes, mediana de 30 sesiones con 6 meses de tratamiento y 40 meses (6-68 meses)de seguimiento. El 69,2% obtuvo respuesta completa y el21,2% respuesta parcial. El 53,2% mejoró antes de las 10primeras sesiones. La reducción de los ingresos hospitalarios/año por hematuria fue de 2,8 a 1,1 (p=0,001). El 73,5%de pacientes señaló encontrarse “Mucho mejor” o “un pocomejor” tras el tratamiento. Durante el seguimiento, el15,4% presentaron recurrencia de hematuria. Del total dela serie, 9,6% de pacientes precisó cistectomía de rescate.El análisis de supervivencia mostró una asociación entre eltiempo de desaparición de la hematuria y la clasificación dela escala RTOG-EORTC (OR 3,01 (IC95 1,48-6,16). Todoslos pacientes pudieron finalizar el plan de tratamiento propuesto con buena tolerancia a la THO.Conclusiones: la THO muestra beneficio clínico enel tratamiento de la CRH, redujo los episodios de hospitalización por hematuria y mejoró la calidad de vida de lospacientes, con buena tolerancia al tratamiento. (AU)

Adherence to the Mediterranean diet, is there any relationship with main indices of central fat in adolescent competitive swimmers? / ¿Existe una relación entre la adherencia a la dieta mediterránea y los principales índices de grasa central en nadadores adolescentes de competición?

Introduction: The relationship between adherence to the mediterranean diet and central fat of adolescent competitiveswimmers is under-studied. The fat component is interesting because of its relationship to the horizontal floatation and speedduring the swimming performance. An accumulation of central fat is considered a negative factor for health and performance.This study aimed to check the degree of adherence to the mediterranean diet and its relationship with some indices of centralfat in competitive adolescent swimmers. Material and method: A cross-sectional descriptive study was carried out. 74 adolescent swimmers participated in the study(males n= 34, 14.5 ± 1.3 y.o., females n= 40, 13.6 ± 1.2 y.o.). The swimmers completed the KIDMED questionnaire to assesstheir adherence to the mediterranean diet. A II level ISAK anthropometrist carried out the anthropometric data collection atthe beginning of the evening swimming session. Results: The swimmers showed a medium adherence to the mediterranean diet. Male and female swimmers showed simi-lar KIDMED index score (males 8.09 ± 1.5, females 7.23 ± 2.2). Age seems to be a detrimental factor in the adherence to themediterranean diet during adolescence. Female swimmers showed a significant lower waist/hip ratio compared to males(-0.028; p = 0.01). The adherence to the mediterranean diet was not correlated with the anthropometric measures of central fat.Conclusions: Regardless of the adherence to the mediterranean diet, elevated swimming activity maintains indices of centralfat in healthy values. Despite there was no correlation between adherence to the mediterranean diet and the anthropometricmeasures of central fat, there are reasons related to health to improve healthy eating habits of adolescent competitive swimmers.(AU)

Introducción: La relación entre la adherencia a la dieta mediterránea y la grasa central en nadadores adolescentes está pocoestudiada. La grasa es un componente interesante en natación debido a su relación con la flotabilidad horizontal y la velocidadde nado. Una acumulación de grasa a nivel abdominal se considera un factor negativo para la salud y el rendimiento deportivo. El objetivo de este estudio fue valorar el grado de adherencia a la dieta mediterránea y su relación con los principales índicesde grasa central en nadadores adolescentes de competición.Material y método: Se llevó a cabo un estudio descriptivo transversal. 74 nadadores adolescentes participaron al estudio(chicos n= 34, 14,5 ± 1,3 años, chicas n= 40, 13,6 ± 1,2 años). Se valoró la adherencia a la dieta mediterránea de los nadadoresa través del cues-tionario KIDMED. Los nadadores fueron medidos antes de una sesión de entrenamiento vespertina. Losnadadores mostraron una adherencia moderada a la dieta mediterránea. Resultados: Chicos y chicas mostraron puntuaciones similares (chicos 8,09 ± 1,5, chicas 7,23 ± 2,2). Durante la adolescencia,a mayor edad parece empeorar la adherencia a la dieta mediterránea. Las chicas mostraron un índice cintura-cadera más bajoen comparación con los hombres (-0,028; p = 0,01). No se encontró asociación entre la adherencia a la dieta mediterránea ylos principales índices de grasa central.Conclusiones: Independientemente del grado de adherencia a la dieta mediterránea, la elevada actividad natatoria man-tiene los índices de grasa central en valores saludables en los nadadores adolescentes de competición. A pesar de que noencontramos asociación entre las medidas de grasa central y la adherencia a la dieta mediterránea, existen razones de saludpara implementar habitos alimenticios saludables en nadadores adolescentes de competición.(AU)

Comparisons of summer break effect on anthropometric profile, body composition and somatotype between adolescent swimmers and less active adolescents / Comparación del efecto de las vacaciones de verano en el perfil antropométrico, la composición corporal y el somatotipo entre nadadores adolescentes y adolescentes menos activos

OBJECTIVE: The aim of this study was to compare changes in anthropometric profile, body composition, and somatotype of adolescent swimmers and less active adolescents. METHOD: We selected 16 swimmers and 8 less active adolescents. The swimmers were divided based on the amount of swimming activity performed per week. A longitudinal study with repeated measures was carried out. The anthropometric profile, body composition, and somatotype were assessed before and after the summer break from swimming activity. RESULTS: Both groups of swimmers showed more changes in anthropometric profile, body composition, and somatotype than the less active adolescents. The very active swimmers showed a higher increase in the sum of the two central skinfolds than peripheral ones (p = 0.018). Both groups of swimmers had a great increase of the percent change in the sum of the two central skinfolds (medium active swimmers: p = 0.006, medium effect size = 0.72; very active swimmers: p = 0.001, medium effect size = 0.64). CONCLUSIONS: The fat component seems to be more variable than the muscular and bone component during 55 - 65 days of summer break from swimming activity. The two groups of swimmers showed a preferential accumulation of central fat after the summer break compared to the less active adolescents. The suprailiac and abdominal skinfolds could be used as early predictive measurements to assess changes in body fat

OBJETIVO: El objetivo del estudio fue comparar los cambios en el perfil antropométrico, la composición corporal y el somatotipo entre nadadores adolescentes y adolescentes sedentarios. MÉTODO: Se llevó a cabo un estudio longitudinal con medidas repetidas. Se analizó el perfil antropométrico, la composición corporal y el somatotipo antes y después del verano. Se seleccionaron 24 adolescentes: 16 nadadores y 8 sedentarios. Los nadadores se dividieron en dos grupos según los minutos de entrenamiento realizado por semana: actividad intensa = 960 minutos, actividad media = 480 minutos. RESULTADOS: Los nadadores mostraron mayores cambios en el perfil antropométrico, la composición corporal y el somatotipo respecto a los adolescentes sedentarios tras el verano. Ambos grupos de nadadores tuvieron un aumento en la suma de los dos pliegues centrales (nadadores de actividad media: p = 0.006, tamaño de efecto medio = 0.72; nadadores de actividad intensa: p = 0.001, tamaño de efecto medio = 0.64). Los nadadores de actividad intensa mostraron un aumento en la suma de los dos pliegues centrales frente a los periféricos (p = 0.018). CONCLUSIONES: En nadadores adolescentes, la grasa corporal parece ser más variable frente al componente muscular y óseo después del verano. Ambos grupos de nadadores mostraron una acumulación preferencial de grasa central después del verano frente a los adolescentes sedentarios. Los pliegues centrales podrían usarse como medidas predictivas tempranas para evaluar los cambios en la grasa corporal

[Spanish update of the Kidmed questionnaire, a mediterranean diet quality index in children and adolescents.] / El índice de calidad de la dieta mediterránea en la infancia y la adolescencia (KIDMED). Propuesta de actualización para países hispano hablantes.

Since 2004 the KIDMED questionnaire has been used to evaluate adherence to the mediterranean diet in children and adolescents. During the last decade, there was a paradigm shift about the daily consumption of fruit juice and whole grains. These changes have led to an update of the KIDMED questionnaire in English. We propose an update of the spanish version of the KIDMED questionnaire. We propose deleting 'or fruit juice' from the first question. In the eighth question we propose adding 'whole-grain' to the daily consumption of pasta and rice. In the ninth question, we propose adding 'whole cereals or whole grains' to the consumption of cereals or grain over breakfast. The twelfth question is reformulated as: "Skips breakfast". We propose some modifications to the spanish version KIDMED questionnaire to provide a tool according to the new recommendations for a healthy diet in children and adolescents.

El cuestionario KIDMED ha sido utilizado desde 2004 para evaluar la adherencia a la dieta mediterránea de niños y adolescentes. Desde entonces, ha habido un cambio de paradigma en referencia al consumo diario de zumos de fruta y al consumo de cereales integrales. Proponemos una actualización del cuestionario KIDMED en lengua española. En la primera pregunta se propone quitar la expresión "o un zumo natural". En la octava pregunta se añade el término "integral" al consumo diario de pasta y arroz. En la novena pregunta se añade el término "integral" al consumo de cereales y derivados en el desayuno. En la duodécima pregunta se propone la siguiente reformulación: "Salta el desayuno". Con este trabajo se proponen algunas modificaciones al cuestionario KIDMED en lengua española, con el fin de suministrar una herramienta conforme a las nuevas recomendaciones que se han ido implementando en los últimos años para poder considerar si una dieta es correcta en niños y adolescentes.

El índice de calidad de la dieta mediterránea en la infancia y la adolescencia (KIDMED). Propuesta de actualización para países hispanohablantes / Spanish update of the KIDMED questionnaire, a mediterranean diet quality index in children and adolescents

El cuestionario KIDMED ha sido utilizado desde 2004 para evaluar la adherencia a la dieta mediterránea de niños y adolescentes. Desde entonces, ha habido un cambio de paradigma en referencia al consumo diario de zumos de fruta y al consumo de cereales integrales. Proponemos una actualización del cuestionario KIDMED en lengua española. En la primera pregunta se propone quitar la expresión "o un zumo natural". En la octava pregunta se añade el término "integral" al consumo diario de pasta y arroz. En la novena pregunta se añade el término "integral" al consumo de cereales y derivados en el desayuno. En la duodécima pregunta se propone la siguiente reformulación: "Salta el desayuno". Con este trabajo se proponen algunas modificaciones al cuestionario KIDMED en lengua española, con el fin de suministrar una herramienta conforme a las nuevas recomendaciones que se han ido implementando en los últimos años para poder considerar si una dieta es correcta en niños y adolescentes

Since 2004 the KIDMED questionnaire has been used to evaluate adherence to the mediterranean diet in children and adolescents. During the last decade, there was a paradigm shift about the daily consumption of fruit juice and whole grains. These changes have led to an update of the KIDMED questionnaire in English. We propose an update of the spanish version of the KIDMED questionnaire. We propose deleting 'or fruit juice' from the first question. In the eighth question we propose adding 'whole-grain' to the daily consumption of pasta and rice. In the ninth question, we propose adding 'whole cereals or whole grains' to the consumption of cereals or grain over breakfast. The twelfth question is reformulated as: "Skips breakfast". We propose some modifications to the spanish version KIDMED questionnaire to provide a tool according to the new recommendations for a healthy diet in children and adolescents

Mortalidad por complicaciones médicas y quirúrgicas, impacto de la crisis y gasto sanitario en España, 2002-2013 / Mortality due to medical and surgical complications, economic crisis and health spending in Spain, 2002-2013

Objetivo: Describir la evolución de los riesgos de mortalidad por complicaciones debidas a la atención médica o la cirugía entre los periodos anterior (2002-2007) y posterior (2008-2013) al inicio de la crisis económica, en España y por comunidades autónomas, y analizar la relación entre los cambios en los riesgos de muerte y el impacto socioeconómico de la crisis y la variación del gasto sanitario. Método: Estudio ecológico basado en tasas de mortalidad estandarizadas por edad, índice sintético de vulnerabilidad como indicador socioeconómico y variación del gasto sanitario como indicador del gasto en salud. Se estimó el riesgo relativo de muerte entre periodos con modelos de regresión de Poisson. Resultados: El número de muertes aumentó para España en el periodo estudiado. Aunque la relación entre el incremento en la inversión pública en salud y la disminución de la mortalidad por esta causa no ha quedado claramente demostrada, sí ha podido determinarse que aquellas comunidades autónomas con menor incremento del gasto sanitario presentaron mayores tasas que el resto a lo largo de todo el periodo, y que las más vulnerables a la crisis y con menor incremento del gasto presentaron un mayor incremento de riesgo de muerte entre periodos. Conclusión: Dado el incremento de las muertes debidas a fallos evitables del sistema, es necesario seguir investigando sobre esta causa de mortalidad

Objective: To describe the evolution of mortality risks for complications due to medical care or surgery between the periods prior to (2002-2007) and after (2008-2013) the beginning of the economic crisis for Spain and by autonomous region, and to analyse the relationship between the changes in the risks of death and the socioeconomic impact of the crisis and the variation in health spending. Method: Ecological study based on age-standardized mortality rates, synthetic index of vulnerability as a socioeconomic indicator and variation in health expenditure as an indicator of health expenditure. The relative risk of death between periods was estimated with Poisson regression models. Results: The number of deaths increased for Spain in the period studied. Although the relationship between the increase in public investment in health and the decrease in mortality due to this cause has not been clearly demonstrated, it was possible to determine that the autonomous regions with the lowest increase in health expenditure had rates higher than the rest throughout the period, and that the most vulnerable to the crisis and with the lowest increase in spending presented the greatest increase in the risk of death between the periods. Conclusions: Given the increase in these deaths, due to avoidable failures of the system, it is necessary to continue investigating this cause of mortality

An update of the KIDMED questionnaire, a Mediterranean Diet Quality Index in children and adolescents.

OBJECTIVE: The KIDMED questionnaire was published in 2004 to evaluate adherence to the Mediterranean diet (MD) in children and adolescents. In the last 14 years, several respected official dietetics and health organizations have recommended appropriate dietary habits, including eating whole grains and consuming whole fruit rather than fruit juice. We propose an update of the KIDMED questionnaire. DESIGN: Based on the scientific evidence, the present commentary suggests some changes to the KIDMED questionnaire. RESULTS: We suggest deleting 'or fruit juice' from the first question of the questionnaire, rewording the question as 'Takes a fruit every day', and assigning a positive value of +1. We suggest adding 'whole-grain' to the eighth question of the questionnaire, rewording the question as 'Consumes whole-grain pasta or whole-grain rice almost every day (5 or more times per week)', and assigning a positive value of +1. Further, we propose to add 'whole cereals or whole grains' to the ninth question of the questionnaire, reword the question as 'Has whole cereals or whole grains (whole-meal bread, etc.) for breakfast', and assign a positive value of +1. CONCLUSIONS: The present commentary examines some signs of a paradigm shift about fruit juice and whole grains after the development of the KIDMED questionnaire. The changes are of paramount importance in order to make the questionnaire an updated tool to evaluate adherence to the MD.

[Mortality due to medical and surgical complications, economic crisis and health spending in Spain, 2002-2013]. / Mortalidad por complicaciones médicas y quirúrgicas, impacto de la crisis y gasto sanitario en España, 2002-2013.

OBJECTIVE: To describe the evolution of mortality risks for complications due to medical care or surgery between the periods prior to (2002-2007) and after (2008-2013) the beginning of the economic crisis for Spain and by autonomous region, and to analyse the relationship between the changes in the risks of death and the socioeconomic impact of the crisis and the variation in health spending. METHOD: Ecological study based on age-standardized mortality rates, synthetic index of vulnerability as a socioeconomic indicator and variation in health expenditure as an indicator of health expenditure. The relative risk of death between periods was estimated with Poisson regression models. RESULTS: The number of deaths increased for Spain in the period studied. Although the relationship between the increase in public investment in health and the decrease in mortality due to this cause has not been clearly demonstrated, it was possible to determine that the autonomous regions with the lowest increase in health expenditure had rates higher than the rest throughout the period, and that the most vulnerable to the crisis and with the lowest increase in spending presented the greatest increase in the risk of death between the periods. CONCLUSIONS: Given the increase in these deaths, due to avoidable failures of the system, it is necessary to continue investigating this cause of mortality.

Outcomes of ureteroscopy miniaturization on tissue damage and tissue hypoxia in a pig model.

Miniaturization of ureteroscopy materials is intended to decrease tissue damage. However, tissue hypoxia and the gross and microscopic effects on tissue have not been adequately assessed. We compared the gross and microscopic effects of micro-ureteroscopy (m-URS) and conventional ureteroscopy (URS) on the urinary tract. We employed 14 pigs of the Large White race. URS was performed in one of the ureters with an 8/9.8 F ureteroscope, while a 4.85 F m-URS sheath was used in the contralateral ureter. Gross assessment of ureteral wall damage and ureteral orifice damage was performed. For microscopic assessment hematoxylin-eosin staining and immunohistochemistry for detection of tissue hypoxia were conducted. Regarding the macroscopic assessment of ureteral damage, substantial and significant differences were recorded using URS (C = 0.8), but not with m-URS. Microscopic assessment after staining with hematoxylin-eosin revealed greater epithelial desquamation in the URS group (p < 0.05). Pimonidazole staining revealed greater hypoxia in the epithelial cells than in the remainder of the ureteral layers. We conclude that m-URS causes less damage to the ureteral orifice than URS. Histopathological findings show m-URS reduces ureteral epithelial damage compared with conventional ureteroscopy. Both URS and m-URS cause cellular hypoxia.

Micro-ureteroscopy vs. ureteroscopy: effects of miniaturization on renal vascularization and intrapelvic pressure.

PURPOSE: Ureteroscopy (URS) is related to complications, as fever or postoperative urinary sepsis, due to high intrapelvic pressure (IPP) during the procedure. Micro-ureteroscopy (m-URS) aims to reduce morbidity by miniaturizing the instrument. The objective of this study is to compare IPP and changes in renal haemodynamics, while performing m-URS vs. conventional URS. METHODS: A porcine model involving 14 female pigs was used in this experimental study. Two surgeons performed 7 URS (8/9.8 Fr), for 45 min, and 7 m-URS (4.85 Fr), for 60 min, representing a total of 28 procedures in 14 animals. A catheter pressure transducer measured IPP every 5 min. Haemodynamic parameters were evaluated by Doppler ultrasound. The volume of irrigation fluid employed in each procedure was also measured. RESULTS: The range of average pressures was 5.08-14.1 mmHg in the m-URS group and 6.08-20.64 mmHg in the URS (NS). 30 mmHg of IPP were not reached in 90% of renal units examined with m-URS, as compared to 65% of renal units in the URS group. Mean peak diastolic velocity decreased from 15.93 to 15.22 cm/s (NS) in the URS group and from 19.26 to 12.87 cm/s in the m-URS group (p < 0.01). Mean resistive index increased in both groups (p < 0.01). Irrigation fluid volume used was 485 mL in the m-URS group and 1475 mL in the URS group (p < 0.001). CONCLUSIONS: m-URS requires less saline irrigation volumes than the conventional ureteroscopy and increases renal IPP to a lesser extent.

Effect of Different Feedback Modalities on Swimming Pace: Which Feedback Modality is Most Effective?

To compare the effect of three different feedback modalities on swimming pace, sixteen male swimmers and triathletes participated in this study. Each participant swam 3 x 400 m, one for each feedback modality, swimming front crawl at 80% of their individual swimming critical speed. Three feedback modalities were examined: self-pacing, real time visual feedback and real time voice feedback. The swimmers adopted a fast start in all feedback modalities. In the real time voice feedback modality, the data recorded during the second lap (200 m) showed a significant improvement of their swimming pace approaching the swimming pace intended (-1.47 s, p < .01, medium effect size 0.79). A significant improvement toward the swimming pace intended was also noticed at the third split time (300 m) (0.05 s, p < .01, large effect size 0.81) and at the fourth split time (400 m) (0.46 s, p < .01, medium effect size 0.76). In self-pacing, the swimmers were not able to swim in line with the swimming pace intended. In real time visual feedback modality, the swimmers did not show a significant improvement approaching the swimming pace intended. The results revealed that communication with the swimmers using the real time voice feedback induced a significant improvement in their swimming pace and could help the athletes to swim with accurate and consistent pace.

Assessment of the Effectiveness, Safety, and Reproducibility of Micro-Ureteroscopy in the Treatment of Distal Ureteral Stones in Women: A Multicenter Prospective Study.

PURPOSE: The aim of this study is to assess the effectiveness, safety, and reproducibility of the micro-ureteroscopy (m-URS) in the treatment of distal ureteral stones in women. MATERIALS AND METHODS: A multicenter, prospective observational study was designed and conducted between March and December 2015. We included women having at least one stone in the distal ureter and being a candidate for surgical treatment using the 4.85F sheath of MicroPerc®. Patients with clinical criteria and/or laboratory analysis indicating sepsis or coagulation alteration were excluded. RESULTS: Thirty-nine women were operated in eight hospitals. The profile of the patients was fairly homogeneous among hospitals. Only differences were found in age, preoperative stent, and the result of the previous urine culture. Immediate stone-free status was achieved in 88.2% and 100% 7 days after the procedure. 97.4% of patients did not present any complication in the postoperative period, with only one case with complication Clavien II. Postureteroscopic Lesion Scale (PULS) in 76.9% of patients did not show any injury, 20.5% had lesions grade 1, and grade 2 lesions 2.6%. As for the reproducibility of m-URS between hospitals, statistical analysis of the results showed differences between all the centers participating in the study. CONCLUSIONS: m-URS is an effective, safe, and reproducible technique that minimizes surgical aggression to the ureteral anatomy. Satisfactory and comparable results to "conventional" ureteroscopy were obtained in the treatment of distal ureteral stones in women, although clinical trials are needed. The reduction of the ureteral damage may reduce secondary procedures and increase the cost-effectiveness of the procedure.

[Acceptability of the HPV vaccine among Spanish university students in the pre-vaccine era: a cross-sectional study]. / Aceptabilidad de la vacuna contra el VPH en estudiantes universitarios españoles durante la etapa pre-vacunal: un estudio transversal.

INTRODUCTION: Cervical cancer (CC), the second most common cause of cancer deaths in women, is associated with the infection of human papillomavirus (HPV) and is more prevalent in women between the ages of 20 and 24. This research is aimed to determine the background about CC, the human papillomavirus infection and its vaccine, assessing its acceptability in university students. METHODS: Cross-sectional study over 1,750 students from the University of Alicante (2008) selected at random, proportional associated to gender and studies, by a validated ad-hoc questionnaire. Percentages were computed, confidence intervals, contingency tables according to sex, age and type of studies, calculating adjusted odd ratios (OR). RESULTS: A sample with 58.6 % of women and 6.6% of biohealth students was obtained. 87.3% were willing to have the vaccine to prevent human papillomavirus (HPV), 94.3% would give this vaccine to their daughters, and 48.0% had heard someone talk about the vaccine. 90.6% didn't have a lot of knowledge about the HPV infection and 82.2% didn't know much about the vaccine. 22.4% had knowledge of the association between HPV and CC. Women register higher OR in acknowledging the problem and are more receptive to having the vaccine. The HPV vaccine acceptability is associated to the sex, the confidence of vaccines as a preventive method; the influence of the background is low in relation to the vaccine predisposition. CONCLUSIONS: A high acceptability of the vaccine was observed in the period of the study. Raising confidence in people about the vaccines can influence for a better predisposition to be vaccinated.

Aceptabilidad de la vacuna contra el VPH en estudiantes universitarios españoles durante la etapa pre-vacunal: un estudio transversal / Acceptability of the HPV vaccine among Spanish university students in the pre-vaccine era: a cross-sectional study

Introducción. El cáncer de cuello de útero (CCU), segunda causa de mortalidad por cáncer en mujeres, está asociado a la infección por virus de papiloma humano (VPH), cuya máxima prevalencia se sitúa entre los 20 y 24 años de edad. Desde 2006 se dispone de una vacuna contra el VPH. El objetivo de este estudio es evaluar los conocimientos sobre CCU, la infección por VPH y su vacuna, valorando su aceptabilidad en población universitaria. Métodos. Estudio transversal sobre 1.750 estudiantes de la Universidad de Alicante (2008) seleccionados al azar, proporcional por sexo y estudios, mediante un cuestionario ad-hoc validado. Se calcularon porcentajes, intervalos de confianza, tablas de contingencia según sexo, edad y tipo de estudios, calculando odds ratios ajustadas (OR). Resultados. Muestra con 58,6% mujeres y 6,6% de estudiantes biosanitarios. Un 87,3% dispuestos a vacunarse frente al VPH, el 94,3% vacunaría a sus hijas, un 48,0% había oído hablar de la vacuna. El 90,6% tiene bajos conocimiento sobre la infección por VPH y un 82,2% sobre la vacuna. Un 22,4% manifiesta conocer la asociación entre VPH y CCU. Las mujeres registran OR mayores en conocimientos y predisposición a vacunarse. La aceptabilidad de la vacuna contra VPH se asocia con el sexo y la confianza en las vacunas como método preventivo, la influencia de los conocimientos previos es escasa sobre la predisposición vacunal. Conclusiones. Alta aceptabilidad de la vacuna en el periodo estudiado. Aumentar la confianza hacia las vacunas puede influir en una mejor predisposición a vacunarse (AU)

Introduction. Cervical cancer (CC), the second most common cause of cancer deaths in women, is associated with the infection of human papillomavirus (HPV) and is more prevalent in women between the ages of 20 and 24. This research is aimed to determine the background about CC, the human papillomavirus infection and its vaccine, assessing its acceptability in university students. Methods. Cross-sectional study over 1,750 students from the University of Alicante (2008) selected at random, proportional associated to gender and studies, by a validated ad-hoc questionnaire. Percentages were computed, confidence intervals, contingency tables according to sex, age and type of studies, calculating adjusted odd ratios (OR). Results. A sample with 58.6 % of women and 6.6% of biohealth students was obtained. 87.3% were willing to have the vaccine to prevent human papillomavirus (HPV), 94.3% would give this vaccine to their daughters, and 48.0% had heard someone talk about the vaccine. 90.6% didn´t have a lot of knowledge about the HPV infection and 82.2% didn´t know much about the vaccine. 22.4% had knowledge of the association between HPV and CC. Women register higher OR in acknowledging the problem and are more receptive to having the vaccine. The HPV vaccine acceptability is associated to the sex, the confidence of vaccines as a preventive method; the influence of the background is low in relation to the vaccine predisposition. Conclusions. A high acceptability of the vaccine was observed in the period of the study. Raising confidence in people about the vaccines can influence for a better predisposition to be vaccinated (AU)

Ensayo clínico controlado y aleatorizado para determinar los efectos del uso de pelotas de parto durante el trabajo de parto / Randomised controlled clinical trial to determine the effects of the use of birth balls during labour

Objetivo. Determinar los efectos del uso de la pelota de parto (PdP) durante el trabajo de parto en relación al tiempo de dilatación y expulsivo, la integridad perineal, la percepción de la intensidad del dolor y la seguridad. Método. Ensayo clínico controlado y aleatorizado. Participantes: nulíparas de 18 a 35 años, bajo riesgo, a término. Intervención: realización de movimientos sentadas sobre PdP durante el parto. Variables resultado: tiempo de dilatación y expulsivo; integridad perineal; percepción del dolor, recuerdo del dolor en el puerperio y pre-post intervención; tipo de parto; motivo de distocia; Apgar; ingreso en UCI neonatal. Análisis: comparación de grupos: t-Student para variables contínuas y Ji-cuadrado para categóricas. Significación p≤0,05. Resultados: 58 participantes (34 grupo experimental y 24 grupo control). El tiempo de dilatación y expulsivo, y la integridad perineal fue similar entre grupos. A los 4cm el grupo experimental refirió menos dolor que el grupo control; 6,9 puntos vs 8,2 (p=0,039). La diferencia en la percepción del dolor recordada en el puerperio inmediato fue de 1,48 puntos mayor en el grupo control (p=0,003). La medición del dolor en el grupo experimental antes del uso de la PdP fue de 7,45 puntos y tras la intervención de 6,07 puntos (p<0,001). En las variables relacionadas con la seguridad no hubo diferencias entre los grupos. Conclusión. El uso de pelotas de parto disminuye la percepción del dolor de parto y es segura (AU)

Objective. To determine the effects of using birth balls (BB) during the first and second stage of labour, perineal integrity, perception of pain intensity, and safety. Method: Randomised controlled trial. Participants: 18 to 35 years, nulliparous, low-risk, at term. Intervention: Performing movements sitting on a BB during obstetric labour. Main outcomes: Duration of first and second labour stages; perineal integrity; pain perception during the postpartum period and pre-post intervention, type of delivery, cause of dystocia, Apgar, neonatal ICU admission. Analysis: Comparison of groups: Student-t for continuous variables and chi-squared test for categorical ones. Significance if P ≤.05. Results. A total of 58 patients (34 experimental and 24 controls) were included. Times of first and second stage, and perineal integrity were similar between groups. At 4cm. the experimental group referred less pain than the control group, 6.9 points vs 8.2 (P=.039). Difference in the perception of pain in the immediate postpartum period was 1.48 points higher in the control group (P=.003). The measurement of pain in the experimental group before the use of the BB was of 7.45 points, and after the intervention of 6.07 points (P<.001). In There were no differences between groups as regards safety-related variables. Conclusion. The use of a Birth Ball decreases obstetric labour pain perception and is safe (AU)

[Randomised controlled clinical trial to determine the effects of the use of birth balls during labour]. / Ensayo clínico controlado y aleatorizado para determinar los efectos del uso de pelotas de parto durante el trabajo de parto.

OBJECTIVE: To determine the effects of using birth balls (BB) during the first and second stage of labour, perineal integrity, perception of pain intensity, and safety. METHOD: Randomised controlled trial. PARTICIPANTS: 18 to 35 years, nulliparous, low-risk, at term. INTERVENTION: Performing movements sitting on a BB during obstetric labour. MAIN OUTCOMES: Duration of first and second labour stages; perineal integrity; pain perception during the postpartum period and pre-post intervention, type of delivery, cause of dystocia, Apgar, neonatal ICU admission. ANALYSIS: Comparison of groups: Student-t for continuous variables and chi-squared test for categorical ones. Significance if P ≤.05. RESULTS: A total of 58 patients (34 experimental and 24 controls) were included. Times of first and second stage, and perineal integrity were similar between groups. At 4 cm. the experimental group referred less pain than the control group, 6.9 points vs 8.2 (P=.039). Difference in the perception of pain in the immediate postpartum period was 1.48 points higher in the control group (P=.003). The measurement of pain in the experimental group before the use of the BB was of 7.45 points, and after the intervention of 6.07 points (P<.001). In There were no differences between groups as regards safety-related variables. CONCLUSION: The use of a Birth Ball decreases obstetric labour pain perception and is safe.

[Bibliografic resources on chemical risk administration and prevention]. / Recursos bibliográficos sobre gestión y prevención del riesgo químico.

BACKGROUND: The documentation produced by public and private institutions in relation to the chemical risk constitutes an essential tool for prevention. The objective of this research is to locate and to revise the documents related to the management of the prevention of chemical risk focus to PYMES in Spain from 1995 to 2004. METHODS: The methodology carried out for the selection of the bibliographical materials has been the consultation of automated databases and Web pages. RESULTS: 812 documents have been identified. Most corresponds to grey literature. The thematic more frequent has been the security and the most frequent objective of the papers has been the prevention. Most of the documents go to the technical sector. CONCLUSIONS: The results suggest that although that there is a great diversity of documents in Spain dedicated to the prevention of chemical risk it seems convenient: 1) to increase their diffusion, 2) to pay attention to the communication of the risks, 3) to investigate and to translate the research in good practice.

Recursos bibliográficos sobre gestión y prevención del riesgo químico / Bibliografic resources on chemical risk administration and prevention

Fundamento: La documentación producida por las institucionespúblicas y privadas en relación al riesgo químico constituye unaherramienta esencial para la prevención. El objetivo de este trabajoes localizar y revisar los documentos sobre gestión de la prevenciónde riesgo químico dirigido a PYMES en España desde 1995 hasta2004.Métodos: La metodología seguida para la selección de los materialesbibliográficos ha sido la consulta de bases de datos automatizadasy páginas web.Resultados: Se han identificado 812 documentos. La mayoríacorresponde a literatura gris. La temática más frecuente ha sido la deseguridad y el objetivo más frecuente del trabajo/documento es laprevención. La mayoría de los documentos se dirigen a los técnicosprevencionistas.Conclusiones: Los resultados obtenidos sugieren que si bien seestán publicando en España una gran diversidad de documentosdestinados a la prevención de riesgo químico parece conveniente:1) incrementar su difusión; 2) prestar atención a la comunicaciónde los riesgos, 3) investigar y traducir la investigación en buenasprácticas

Background: The documentation produced by public and privateinstitutions in relation to the chemical risk constitutes anessential tool for prevention. The objective of this research is tolocate and to revise the documents related to the management of theprevention of chemical risk focus to PYMES in Spain from 1995 to2004.Methods: The methodology carried out for the selection of thebibliographical materials has been the consultation of automateddatabases and Web pages.Results: 812 documents have been identified. Most correspondsto grey literature. The thematic more frequent has been the securityand the most frequent objective of the papers has been the prevention.Most of the documents go to the technical sector.Conclusions: The results suggest that although that there is agreat diversity of documents in Spain dedicated to the prevention ofchemical risk it seems convenient: 1) to increase their diffusion, 2) topay attention to the communication of the risks, 3) to investigate andto translate the research in good practice

Tomar decisiones. Una aproximación conceptual / A conceptual approximation to decision making

La toma de decisiones es una constante en todos los ámbitos de la disciplina enfermera (gestión, docencia, investigación y asistencia). Pero, ¿qué podemos decir acerca de los mecanismos y procesos que nos llevan a adoptar una decisión? A partir de las consideraciones realizadas, y teniendo en cuenta que en nuestro país no hay trabajos que aborden la toma de decisiones en enfermería, se efectúa una revisión de la bibliografía que contribuya a una discusión crítica sobre el tema y aporte elementos de reflexión para la toma de decisiones en la práctica cotidiana de la enfermería. Primeramente, abordamos los orígenes y la evolución de los modelos de toma de decisiones en la práctica clínica, para luego analizar la toma de decisiones en enfermería (AU)