ABSTRACT
INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) is a combination of various cardiovascular risk factors with a major impact on morbidity and premature mortality. However, the impact of MetS on self-reported health-related quality of life (HRQoL) is unknown. This study evaluated the HRQoL in a Spanish adult population aged 55 years and older with MetS. METHOD: A cross-sectional analysis was performed with baseline data from the PREDIMED-Plus multicentre randomized trial. The participants were 6430 men and women aged 55-75 years with overweight/obesity (body mass index ≥27 and ≤40kg/m2) and MetS. The SF-36 questionnaire was used as a tool to measure HRQoL. Scores were calculated on each scale of the SF-36 by gender and age. RESULTS: Participants showed higher scores in the social function (mean 85.9, 95% CI; 85.4-86.4) and emotional role scales (mean 86.8, 95% CI; 86.0-87.5). By contrast, the worst scores were obtained in the aggregated physical dimensions. In addition, men obtained higher scores than women on all scales. Among men, the worst score was obtained in general health (mean 65.6, 95% CI; 65.0-66.2), and among women, in body pain (mean 54.3, 95%CI; 53.4-55.2). A significant decrease was found in the aggregated physical dimensions score among participants 70-75 years old, but an increased one in the aggregated mental dimensions, compared to younger participants. CONCLUSIONS: Our results reflect that the MetS may negatively affect HRQoL in the aggregated physical dimensions, body pain in women, and general health in men. However, this adverse association was absent for the psychological dimensions of HRQoL, which were less affected
INTRODUCCIÓN Y OBJETIVOS: El síndrome metabólico (SM) es la combinación de diversos factores de riesgo cardiovascular que pueden derivar en un mayor impacto en la morbimortalidad prematura. Sin embargo, el impacto del SM en la calidad de vida relacionada con la salud (CVRS) es desconocido. El objetivo de este estudio es evaluar la CVRS en la población adulta española de 55 años o más con SM. MÉTODOS: Se realizó un análisis transversal con los datos del ensayo PREDIMED-Plus. Seis mil cuatrocientos treinta varones y mujeres entre 55-75 años con sobrepeso/obesidad y SM. El instrumento de medida de la CVRS fue el cuestionario SF-36. Cada escala del SF-36 fue descrita y estratificada por sexo. RESULTADOS: Los participantes mostraron valores más altos en las escalas función social (media: 85,9; IC 95%: 85,4-86,4) y rol emocional (media: 86,8; IC 95%: 86,0-87,5). En los varones, la peor puntuación fue en la dimensión salud general (media: 65,6; IC 95%: 65,0-66,2) y en las mujeres el dolor corporal (media: 54,3; IC 95%: 53,4-55,2). Además, los varones obtuvieron puntuaciones más altas en todas las escalas. En la escala función física en varones se encontró una disminución significativa de la CVRS en los participantes entre 70 y 75 años en comparación con los más jóvenes. Las peores puntuaciones se obtuvieron en las dimensiones físicas agregadas. CONCLUSIONES: El SM afecta de manera negativa a la CVRS en las dimensiones agregadas físicas, haciendo especial hincapié en la esfera dolor corporal en mujeres y salud general en varones. Sin embargo, las esferas psicológicas se encuentran menos afectadas por el SM
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Metabolic Syndrome/psychology , Quality of Life , Socioeconomic Factors , Cross-Sectional StudiesABSTRACT
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Humans , Social Networking , Information Dissemination/ethics , Scientific Publication Ethics , Censorship, Research , Science , Biomedical Research/ethics , Information Services , Use of Scientific Information for Health Decision Making , Mass Media , Social Media , TrustABSTRACT
Although cardiac cytosolic cyclic 3',5'-adenosine monophosphate (cAMP) regulates multiple processes, such as beating, contractility, metabolism and apoptosis, little is known yet on the role of this second messenger within cardiac mitochondria. Using cellular and subcellular approaches, we demonstrate here the local expression of several actors of cAMP signaling within cardiac mitochondria, namely a truncated form of soluble AC (sACt) and the exchange protein directly activated by cAMP 1 (Epac1), and show a protective role for sACt against cell death, apoptosis as well as necrosis in primary cardiomyocytes. Upon stimulation with bicarbonate (HCO3(-)) and Ca(2+), sACt produces cAMP, which in turn stimulates oxygen consumption, increases the mitochondrial membrane potential (ΔΨm) and ATP production. cAMP is rate limiting for matrix Ca(2+) entry via Epac1 and the mitochondrial calcium uniporter and, as a consequence, prevents mitochondrial permeability transition (MPT). The mitochondrial cAMP effects involve neither protein kinase A, Epac2 nor the mitochondrial Na(+)/Ca(2+) exchanger. In addition, in mitochondria isolated from failing rat hearts, stimulation of the mitochondrial cAMP pathway by HCO3(-) rescued the sensitization of mitochondria to Ca(2+)-induced MPT. Thus, our study identifies a link between mitochondrial cAMP, mitochondrial metabolism and cell death in the heart, which is independent of cytosolic cAMP signaling. Our results might have implications for therapeutic prevention of cell death in cardiac pathologies.
Subject(s)
Apoptosis , Calcium/metabolism , Cyclic AMP/pharmacology , Mitochondria, Heart/metabolism , Signal Transduction/drug effects , Adenylyl Cyclases/chemistry , Adenylyl Cyclases/genetics , Adenylyl Cyclases/metabolism , Animals , Apoptosis/drug effects , Bicarbonates/pharmacology , Camptothecin/toxicity , Cells, Cultured , Dactinomycin/toxicity , Guanine Nucleotide Exchange Factors/antagonists & inhibitors , Guanine Nucleotide Exchange Factors/genetics , Guanine Nucleotide Exchange Factors/metabolism , Heart Ventricles/metabolism , Heart Ventricles/pathology , Hydrogen Peroxide/toxicity , Male , Membrane Potential, Mitochondrial/drug effects , Mitochondria, Heart/drug effects , Myocytes, Cardiac/cytology , Myocytes, Cardiac/metabolism , Permeability , Rats , Rats, Wistar , Troponin I/metabolismABSTRACT
El dolor es un fenómeno complejo y multidimensional mediado por procesos psicoquímicos en el sistema nervioso periférico y central, cuya percepción puede modificarse considerablemente a través de una serie de mecanismos que incluyen, entre otros, fármacos, estímulos ambientales, procesos cognoscitivos y emocionales, así como condiciones sociales y culturales. La gran parte de los agentes farmacológicos que se utiliza en odontología tiene por objeto controlar la angustia y el dolor. En términos generales, la eliminación de la sensación de dolor en el ámbito dental requiere el bloqueo de la percepción del dolor por vía periférica, mediante anestesia local o por vía central, con anestesia general (AU)
Pain is a complex and multidimensional event regulated by psycho-chemical processes in the peripheral and central nervous system; pain perception can be modified by different mechanisms that include, between others, drugs, environmental stimuli, cognoscitive and emotional processes, and cultural and social conditions. The drugs that are used in odontology try to control the pain. In general, it is necessary to stop the peripheral and central pain perception using local or general anesthesia, respectively (AU)
Subject(s)
Child , Female , Humans , Male , Pain Management/methods , Pain Management , Pediatric Dentistry/standards , Pediatric Dentistry/trends , Anesthesiology/instrumentation , Anesthesiology/standards , Conscious Sedation/methods , Dental Care for Children/instrumentation , Dental Care for Children/methods , Analgesics, Opioid/pharmacokinetics , Analgesics, Opioid/therapeutic use , Anesthesia, Local , Deep Sedation , Behavior Therapy/methods , Behavior Therapy/trendsABSTRACT
Amphibians and reptiles (herps) are the most abundant and diverse vertebrate taxa in tropical ecosystems. Nevertheless, little is known about their role in maintaining and regulating ecosystem functions and, by extension, their potential value for supporting ecosystem services. Here, we review research on the ecological functions of Neotropical herps, in different sources (the bibliographic databases, book chapters, etc.). A total of 167 Neotropical herpetology studies published over the last four decades (1970 to 2014) were reviewed, providing information on more than 100 species that contribute to at least five categories of ecological functions: i) nutrient cycling; ii) bioturbation; iii) pollination; iv) seed dispersal, and; v) energy flow through ecosystems. We emphasize the need to expand the knowledge about ecological functions in Neotropical ecosystems and the mechanisms behind these, through the study of functional traits and analysis of ecological processes. Many of these functions provide key ecosystem services, such as biological pest control, seed dispersal and water quality. By knowing and understanding the functions that perform the herps in ecosystems, management plans for cultural landscapes, restoration or recovery projects of landscapes that involve aquatic and terrestrial systems, development of comprehensive plans and detailed conservation of species and ecosystems may be structured in a more appropriate way. Besides information gaps identified in this review, this contribution explores these issues in terms of better understanding of key questions in the study of ecosystem services and biodiversity and, also, of how these services are generated.
Los anfibios y reptiles (herpetos) son dos de los grupos de vertebrados más abundantes y diversos en los ecosistemas Neotropicales. Sin embargo, poco se conoce sobre su papel en el mantenimiento y la regulación de las funciones del ecosistema y, por extensión, de su potencial aporte en el suministro de servicios ecosistémicos. En este estudio se realizó una revisión sobre las funciones ecológicas de los herpetos Neotropicales, usando diferentes recursos (búsqueda en bases de datos, capítulos de libros, etc.). Se revisó un total de 167 estudios de herpetología Neotropical, publicados en las últimas cuatro décadas (1970-2014). Estos estudios proporcionaron información sobre más de 100 especies que contribuyen al menos con cinco categorías de funciones ecológicas: i) ciclaje de nutrientes; ii) bioturbación; iii) polinización; iv) dispersión de semillas, y; v) flujo de energía a través de los ecosistemas. Muchas de estas funciones proveen servicios ecosistémicos claves para el bienestar humano, como el control biológico de especies plaga, dispersión de semillas y calidad del agua. Al conocer y entender las funciones que ejercen los herpetos en los ecosistemas se podrán estructurar de una forma más adecuada planes de manejo en paisajes transformados, proyectos de restauración o recuperación de paisajes que involucren sistemas acuáticos y terrestres, y planes completos y detallados de conservación de especies y ecosistemas. Además de los vacíos de información detectados en la presente revisión, esta contribución profundiza en la comprensión de algunas preguntas claves en el estudio de los servicios ecosistémicos y la biodiversidad y, además, de cómo se generan estos servicios.
Os anfibios e répteis são dois dos grupos de vertebrados mais abundantes e diversos nos ecossistemas neotropicais. No entanto, pouco se sabe sobre o seu papel na manutenção e regulação das funções dos ecossistemas e sua potencial contribuição para o fornecimento de serviços ecossistémicos. Neste estudo, foi realizada uma avaliação sobre as funções ecológicas dos anfibios e répteis neotropicais, utilizando diferentes recursos (busca em bases de dados, capítulos de livros, etc.). Um total de 167 estudos publicados nas últimas quatro décadas (19702014) foram encontrados sobre as funções ecológicas dos anfibios e répteis neotropicais os quais forneceram informações sobre mais de 100 espécies que contribuem no: i) ciclo de nutrientes; ii) bioturbação; iii) polinização; iv) dispersáo de sementes, e; v) fluxo de energía através dos ecossistemas. Enfatizamos a necessidade de desenvolver estudos para ampliar o conhecimento das funções ecológicas dos ecossistemas neotropicais e os mecanismos por detrás destes, através do estudo das características funcionais e análise dos processos ecológicos. Muitas destas funções estao relacionadas com os principais serviços ecossistémicos para o bem estar humano como o controle biológico de espécies de pragas, dispersao de sementes e qualidade da água. Ao conhecer e compreender as funções que desempenham os repteis nos ecossistemas, podem ser estruturados planos de gestao nas paisagens culturais, projetos de restauração ou recuperação de paisagens que envolvem sistemas aquáticos e terrestres, e desenvolver planos abrangentes e detalhados de conservação de espécies e ecossistemas. Além das lacunas de informação identificadas nesta avaliação, esta contribuição explora essas questóes em termos de uma melhor compreensao das questóes-chave no estudo dos serviços dos ecossistemas e da biodiversidade além de como esses serviços são gerados.
ABSTRACT
Purpose: To identify a novel system for scoring intratumoral immune response that can improve prognosis and therapy decisions in early stage non-small cell lung cancer (NSCLC). Methods/patients: Eighty-four completely resected stage I/II NSCLC without adjuvant therapy were classified by expression profiling using whole genome microarrays. An external cohort of 162 tumors was used to validate the results. Immune cells present in tumor microenvironment were evaluated semiquantitatively by CD20, CD79, CD3, CD8, CD4 and CD57 immunostaining. Univariate and multivariate analyses of variables associated with recurrence-free survival were performed. Results: Initial molecular classification identified three clusters, one with significantly better RFS. A reduced two-subgroup classification and a 50-gene predictor were built and validated in an external dataset: high and low risk of recurrence patients (HR = 3.44; p = 0.001). Analysis of the predictor´s genes showed that the vast majority were related to a B/plasma cell immune response overexpressed in the low-risk subgroup. The predictor includes genes coding for unique B lineage-specific genes, functional elements or other genes that, although non-restricted to this lineage, have strong influence on B-cell homeostasis. Immunostains confirmed increased B-cells in the low-risk subgroup. Gene signature (p < 0.0001) and CD20 (p < 0.05) were predictors for RFS, while CD79 and K-RAS mutations showed a tendency. Conclusions: Favorable prognosis in completely resected NSCLC is determined by a B-cell-mediated immune response. It can be differently scored by a 50-gene expression profile or by CD20 immunostaining. That prognosis information not reflected by traditional classifications may become a new tool for determining individualized adjuvant therapies (AU)
No disponible
Subject(s)
Humans , Lung Neoplasms/pathology , Genes, MHC Class II , Gene Expression , Tumor Escape , Carcinoma, Non-Small-Cell Lung/pathology , Neoplasm Recurrence, Local/pathologyABSTRACT
El modelo sanitario tradicional se enfrenta actualmente a nuevas demandas de salud. La implantación de un sistema integrado de salud urológica puede ser una de las posibles soluciones a estas necesidades. Se requiere, por tanto, desarrollar e implementar un nuevo modelo asistencial, que incluya cambios a nivel estructural y organizativo. La adecuación de los Servicios de Urología de la Red hospitalaria idcsalud-Madrid, construyendo UroRed, constituye un nuevo sistema que se adapta a dichos cambios del entorno, para incrementar su profesionalidad y mejorar la calidad asistencial. Objectivos: Describir la gestión clínica de un Servicio de Urología corporativo (UroRed en idcsalud, Madrid) dentro de un modelo asistencial de Red de hospitales RISS (Red Integrada en Servicios de Salud). Métodos: En el período comprendido entre Noviembre de 2007 a Octubre de 2014, el Servicio de UROLOGIA del Grupo idcsalud Madrid, ha ido modelando un sistema organizativo constituido por 4 hospitales, con un equipo actual de 27 urólogos. Cada centro, ofrece y presta una determinada cartera de servicios especializados, compartiendo prestaciones y recursos humanos. Los diferentes equipos están gobernados por una misma línea de actuación. Resultados: El modelo ofrece una atención urológica integral y uniforme, dirigida a una población de 811.390 habitantes (Censo poblacional 2012), con capacidad concreta para la resolución de patologías específicas y continuidad clínica y asistencial. Conclusiones: Pertenecer a un modelo asistencial en red implica una modificación, un cambio de actitud. Conlleva un cambio organizacional basado en los procesos y los resultados que permitan controlar la gestión analíticamente, permitiendo detectar los puntos que requieren ser optimizados así como aquellos que resulten satisfactorios. Implica, por tanto, desarrollar una cultura de aprendizaje y cooperación para que los procesos sean fluidos y de calidad; crear proyectos clínicos y tecnológicos a favor de nuevas investigaciones generando recursos en base a las necesidades de la gestión conjunta del hospital. La complejidad de este modelo, requiere un trabajo centrado en las personas, sus inquietudes y su capacidad de coordinar acciones para obtener resultados en términos de calidad y profesionalidad asistencial
The traditional health care model is currently facing new health requirements. The implementation of integrated urologic health systems can be one of the possible solutions to these needs. It is mandatory to explore a new health care model, which includes structural and organizational changes. The adequacy of the urology departments of IDCsalud-Madrid network hospitals, creating URORed, is a new system adaptable to constant changes, in order to offer professionalism and quality health care. Objective: To describe the administrative/clinic management in the urology service of a health care model of Hospitals network (URORed at IDCsalud. Madrid), that has been included in a model of an Integrated network in a health care service. Methods: In the period between November 2007 to October 2014, the urology departments of IDCsalud Madrid Group, have been included in a new organizational system, including 4 hospitals, currently with 27 urologists. Each center offers specific urologic services, sharing benefits and human resources. The same directive line leads all centers. Results: The model offers an integrated and uniform urologic service to a specific population of 811.390 habitants (Population Census 2012), with capability to treat specific urologic diseases and to perform a correct clinical follow-up. Conclusions: Belonging to a health care model in network involves a change of attitude. It creates an organizational change, based on the processes and the results, which enables control of the management analytically, detecting the points that need to be optimized as well as those that are satisfactory. It implies developing a culture of learning and cooperation, so that the processes are fluent and have quality, to create clinical and technological projects in favor of new resource-generating research, based on the needs of the joint management of the hospitals network. The complexity of this model requires a work focused on the human resources, their concerns and their ability to coordinate actions to get results in terms of quality health care and professionalism
Subject(s)
Humans , Male , Female , Urology/ethics , Community Networks/classification , Community Networks/standards , Practice Patterns, Physicians'/legislation & jurisprudence , Organization and Administration/economics , Urology/education , Community Networks/organization & administration , Practice Patterns, Physicians'/ethics , Practice Patterns, Physicians'/organization & administration , Organization and Administration/standardsABSTRACT
OBJETIVOS: Analizar variabilidad glucémica, el estrés oxidativo y la relación entre ambos en un grupo de en niños y adolescentes con diabetes tipo 1 (DM1) que asistieron a un campamento. Pacientes y método: Estudio transversal que incluyó a 54 niños con DM1 entre 7 y 16 años de edad que asistieron a un campamento de verano de 7 días. Se recogieron datos sociodemográficos, clínicos y valores de glucemia capilar medidos con un glucómetro Accu-Chek Nano(R). Se calcularon los marcadores de variabilidad glucémica: desviación estándar (DE), índice de glucemia baja (LBGI), índice de glucemia elevada (HBGI), amplitud media de las excursiones glucémicas (MAGE) y media de las diferencias diarias (MODD). El estrés oxidativo fue evaluado mediante la medición de 8-iso-prostaglandina F2 alfa (PGF2α) en una muestra de orina de 24 h recogida en 14 niños al final del campamento. RESULTADOS: La mediana de DE, MAGE y MODD se encontraron en un rango elevado (61, 131 y 59mg/dl, respectivamente), LBGI en la categoría de riesgo moderado (3,3) y HBGI en la categoría de riesgo bajo (4,5). La media de HbA1c fue del 7,6%. La media de la tasa de excreción urinaria de 8-iso-PGF2α fue 864,39pg/mg creatinina. No se encontraron correlaciones estadísticamente significativas entre marcadores de variabilidad glucémica y 8-iso PGF2α urinario. CONCLUSIONES: Se ha objetivado una alta variabilidad glucémica en niños y adolescentes con DM1 asistentes a un campamento de verano. Sin embargo, no se han encontrado correlaciones entre marcadores de variabilidad glucémica y de estrés oxidativo medido por 8-iso-PGF2α urinario
OBJECTIVE: To assess glycemic variability, oxidative stress and their relationship in children and adolescents with type 1 diabetes (T1DM) attending a summer camp. PATIENTS AND METHOD: Cross-sectional study that included 54 children and adolescents with T1DM aged 7-16, attending a 7 day summer camp. Sociodemographic information, clinical data, and blood glucose values measured using an Accu-Chek Nano(R) glucose meter were recorded. Glucose variability markers (standard deviation [SD], low blood glucose index [LBGI], high blood glucose index [HBGI], mean amplitude of glycemic excursions [MAGE] and mean of daily differences [MODD]) were calculated. Oxidative stress was assessed by the measurement of 8-iso-prostaglandin F2 alpha (PGF2α) in a 24-hour urine sample collected at the end of the camp in 14 children. RESULTS: The Median SD, MAGE and MODD indexes were in the high range (61, 131 and 58mg/dl, respectively), LBGI in the moderate range (3.3), and HBGI in the low range (4.5). The mean HbA1c was 7.6% and the median urinary excretion rate of 8-iso-PGF2α was 864.39pg/mg creatinine. The Spearman correlation coefficients between markers of glycemic variability (SD, HBGI, MAGE, MODD) were significant. Non-significant correlations were found between markers of glycemic variability and urinary 8-iso-PGF2α. CONCLUSIONS: High glycemic variability was observed in children and adolescents attending a summer camp. However, no correlations were found between markers of glycemic variability and oxidative stress measured by urinary 8-iso-PGF2α. Further studies are needed to address the relationship between oxidative stress and glycemic variability in children with T1DM
Subject(s)
Humans , Male , Female , Child , Adolescent , Oxidative Stress , Diabetes Mellitus, Type 1/diagnosis , Blood Glucose/analysis , Blood Glucose/isolation & purification , Cross-Sectional Studies/methods , Cross-Sectional Studies/trends , Camping/ethics , Camping/statistics & numerical data , Camping/standards , 28599ABSTRACT
The classification working group of the International Society of Urological Pathology consensus conference on renal neoplasia was in charge of making recommendations regarding additions and changes to the current World Health Organization Classification of Renal Tumors (2004). Members of the group performed an exhaustive literature review, assessed the results of the preconference survey and participated in the consensus conference discussion and polling activities. On the basis of the above inputs, there was consensus that 5 entities should be recognized as new distinct epithelial tumors within the classification system:tubulocystic renal cell carcinoma (RCC), acquired cystic diseaseassociated RCC, clear cell (tubulo)papillary RCC, the MiT family translocation RCCs (in particular t(6;11) RCC), and hereditary leiomyomatosis RCC syndromeassociated RCC.The new classification is to be referred to as the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia.
Subject(s)
Humans , Kidney Neoplasms/pathology , Kidney Neoplasms/prevention & controlABSTRACT
Introducción: La vía oral es la forma de administrar medicación más cómoda, pero puede no ser segura. La disfagia es uno de los factores que dificulta la correcta alimentación y administración de la medicación. Objetivos: La mejora de la administración de la medicación oral en pacientes con disfagia, a través de la adecuación de la forma farmacéutica de los principios prescritos a las texturas toleradas. Métodos: Proyecto piloto de aplicación de un protocolo de disfagia, donde se incluyeron los pacientes ingresados en el Servicio de Medicina Interna-Los Montalvos durante 4 meses. Tras detectarse la sospecha de disfagia, se aplicaba un test de disfagia-viscosidad para conocer las texturas toleradas. Posteriormente se adecuaban las formas farmacéuticas y se indicaban las normas de manipulación de los fármacos para su correcta administración. Resultados: De los 627 pacientes ingresados se incluyeron 23 pacientes, con edad media de 85 años (σ ± 7,4). Las patologías implicadas en la disfagia fueron: demencia (65,2%); enfermedad cerebrovascular (30,4%) y enfermedad de Parkinson (4,4%). La textura óptima para la ingesta fue "pudin" en el 48,0%. Se revisaron 43 principios activos y se realizaron 134 intervenciones: En el 41% de ellas se facilitó la deglución mezclando el fármaco con los alimentos y en el 59% se utilizó la adición de agua y espesante. El 94% de las recomendaciones se consideraron adecuadas. Conclusión: La adecuación de las formas farmacéuticas al grado de disfagia repercute en la mejora de la calidad asistencial implementando la seguridad en los procesos de prescripción y administración de fármacos (AU)
Introduction: The oral route is the most convenient way of administering medication, although it may not be safe. Dysphagia is one of the factors rendering difficult a proper feeding and administration of medication. Objectives: to improve the administration of oral medication in patients with dysphagia by changing the pharmaceutical formulation of the principles prescribed to tolerable textures. Methods: Pilot project for the application of a dysphagia protocol that included the patients admitted to the Internal Medicine Unit at Los Montalvos Center for 4 months. After detecting the suspicion of dysphagia, a dysphagia-viscosity test was applied to know the tolerated textures. Then, the pharmaceutical formulations were adapted and the manipulation instructions for the drugs were indicated for their proper administration. Results: 23 out of 627 admitted patients were included, with a mean age of 85 years (σ ± 7.4). The pathologies implicated in dysphagia were: dementia (65.2%); cerebrovascular disease (30.4%), and Parkinson´s disease (4.4%). The best texture for drug intake was a "pudding" in 48.0%. 43 active ingredients were reviewed and 134 interventions were performed: in 41% of the cases, swallowing was made easier by mixing the drug with the food and in 59% water and a thickener were used. 94% of the recommendations were considered to be appropriate. Conclusion: the adaptation of the pharmaceutical formulations to the degree of dysphagia impacts on the improvement of healthcare quality by implementing safety in drug prescription and administration processes (AU)
Subject(s)
Humans , Deglutition Disorders/complications , Administration, Oral , Preparation Scales , Viscosity , Medication Errors/prevention & control , Drug Prescriptions/statistics & numerical dataABSTRACT
OBJECTIVE: Substance use and abuse is a well known public health risk that peaks in persons between 18 and 25 years of age and is prevalent among university students. While this has been repeatedly documented in developed nations, there have been limited studies in the English-speaking Caribbean. This study therefore sought to assess the prevalence of alcohol, tobacco and marijuana use among university students in the English-speaking Caribbean and any associated risk factors. METHODS: The study was designed as a descriptive, cross-sectional study to assess substance use in full-time, undergraduate students of The University of the West Indies (UWI), Trinidad and Tobago, over a six-month period. Questionnaires were distributed and students asked to self-report on their use of alcohol, tobacco and marijuana during the preceding six months. RESULTS: The six-month prevalence rate for alcohol was 70% and 28% of students were identified as regular users. Binge drinking was estimated at 31%. Muslims were least likely to have used alcohol when compared to other religious groupings. The prevalence rate for tobacco and marijuana was 17% and 13%, respectively. Ten per cent used all three substances. The use ofall three substances was associated with multiple problems. CONCLUSION: We conclude that substance use is common among many students of the UWI but generally lower than reports from other regions of the world. Despite this, substance use is associated with a number ofproblems and immediate educational interventions may be necessary to assist students in making informed and responsible choices.
OBJETIVO: El uso y abuso de sustancias es un riesgo bien conocido de la salud pública, que alcanza sus niveles más altos en personas entre los 18 y 25 años de edad, y es prevaleciente entre estudiantes universitarios. Si bien este fenómeno ha sido documentado una y otra vez en países desarrollados, los estudios en el Caribe anglófono han sido limitados. Por lo tanto, este estudio se propuso evaluar la prevalencia del uso del alcohol, el tabaco, y la marihuana, entre los estudiantes universitarios del Caribe angloparlante, y cualquier factor de riesgo asociado. MÉTODOS: El estudio se diseñó como un estudio descriptivo transversal para evaluar el uso de sustancias en estudiantes de pregrado a tiempo completo en la Universidad de West Indies (UWI), Trinidad y Tobago, por un periodo de seis meses. Se distribuyeron encuestas y se les pidió a los estudiantes entregar auto-reportes sobre el uso que habían hecho del alcohol, el tabaco y la marihuana en los seis meses precedentes. RESULTADOS: La tasa de prevalencia de seis meses para el alcohol fue del 70% y 28% de los estudiantes fueron identificados como usuarios regulares. El consumo de alcohol en forma de borracheras deliberadas se estimó en un 31%. Los musulmanes fueron los menos propensos al consumo de alcohol, en comparación con los restantes grupos religiosos. La tasa de prevalência para el tabaco y la marihuana fue de 17% y 13% respectivamente. El diez por ciento hacía uso de las tres sustancias. El uso de las tres sustancias estaba asociado a múltiples problemas. CONCLUSIÓN: Concluimos que el uso de sustancias es común entre muchos estudiantes de UWI, pero de modo general se halla por debajo de lo que se reporta desde otras regiones del mundo. No obstante, el uso de sustancias se encuentra asociado con un número de problemas, y puede que se requieran intervenciones educacionales inmediatas para ayudar a los estudiantes, de modo que estos puedan tomar decisiones responsables e informadas.
Subject(s)
Adolescent , Female , Humans , Male , Young Adult , Students/statistics & numerical data , Substance-Related Disorders/epidemiology , Universities , Chi-Square Distribution , Cross-Sectional Studies , Prevalence , Religion , Trinidad and Tobago/epidemiology , West Indies/epidemiologyABSTRACT
Los pacientes en programa de diálisis peritoneal representan aproximadamente el 10% de los individuos en diálisis y su distribución es muy variable a lo largo de la geografía española con una media nacional de 47 procedimientos por millón de habitantes. La alta incidencia de enfermedad cardiovascular en pacientes en diálisis peritoneal está condicionada por la presencia casi universal de factores de riesgo cardiovasculares tradicionales (diabetes, hipertensión)y otros factores de riesgo secundarios a la uremia yal proceso inflamatorio que acompaña a la enfermedad ateroesclerótica. La coincidencia en la práctica clínica de patología cardíaca muy diversa en estos pacientes hace pertinente realizar una serie de consideraciones que vistas desde la óptica de la cardiología puedan tener interés para el especialista en nefrología. En esta revisión hemos analizado algunos aspectos de cuatro escenarios cardiológicos que son muy frecuentes en el paciente en diálisis peritoneal: La insuficiencia cardíaca, la enfermedad coronaria, la afectación valvular y la fibrilación auricular (AU)
Patients on peritoneal dialysis account for approximately 10% of individuals on dialysis and are very variably distributed throughout Spain, with a national mean of 47 procedures per million inhabitants. The high incidence of cardiovascular disease in patients on peritoneal dialysis is determined by the almost universal presence of traditional cardiovascular risk factors (diabetes, hypertension)and other risk factors secondary to uremia and the inflammatory process associated to atherosclerotic disease. The concomitant presence in clinical practice of highly diverse heart diseases in these patients makes relevant a number of considerations from the cardiological viewpoint that may be of interest for specialists in nephrology. This review analyzes some aspects off our cardiological conditions that are very common in patients on peritoneal dialysis: heart failure, coronary heart disease, valve involvement, and atrial fibrillation (AU)
Subject(s)
Humans , Renal Insufficiency, Chronic/complications , Peritoneal Dialysis/methods , Cardiovascular Diseases/complications , Echocardiography , Heart Failure/complications , Coronary Disease/complications , Atrial Fibrillation/complications , Heart Valve Diseases/complicationsABSTRACT
Se presenta una estrategia metodológica con el propósito de desarrollar la capacidad de respuesta de los estudiantes ante los cambios constantes del entorno en que se desempeñan en las carreras de medicina, estomatología y enfermería(AU)
A methodological strategy is presented with the objective of developing the capacity of the students to give an answer to the constant changes occurring in the setting in which they carry out their activities in the medical, dental and nursing careers(AU)
Subject(s)
Education, Medical , Learning , Professional CompetenceABSTRACT
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