Guía práctica para el uso de registros visuales en la era del Reglamento General de Protección de Datos de la Unión Europea / Use of visual media in the era of European Union's General Data Protection Regulation: A practice-oriented guideline

El nuevo Reglamento General de Protección de Datos de la Unión Europea (más comúnmente conocido por sus siglas en inglés como «GDPR») conforma un nuevo marco para la protección de datos común para la Unión Europea. Es por ello que los profesionales del ámbito sanitario deben revisar cómo recopilan y comparten datos para garantizar que estos cumplan con todos los estándares. El propósito de este artículo es concienciar sobre el Reglamento General de Protección de Datos de la Unión Europea y proporcionar una guía práctica que ayude a evitar problemas legales en la redacción de artículos o la preparación de comunicaciones científicas que requieran compartir datos personales y visuales. Para hacer esto, se han analizado las más comunes situaciones donde es necesario recoger y utilizar datos personales y visuales, para finalmente dar una serie de respuestas y recomendaciones para todos los escenarios descritos. (AU)

With the European Union's new General Data Protection Regulation, commonly known as “GDPR”, as the new framework for data protection across the European Union, doctors will need to review how they collect and share personal data to ensure they meet the standards. The aim of this article is to raise awareness on the General Data Protection Regulation, and to provide an easy guideline to steer free from legal problems at the time of drafting papers, presenting lectures and sharing personal data and visual media in particular. To do so, we have analysed the most common situations where personal data, and above all visual media, can be collected, giving clear-cut answers and recommendations for all the scenarios. (AU)

Use of visual media in the era of European Union's General Data Protection Regulation: A practice-oriented guideline.

With the European Union's new General Data Protection Regulation, commonly known as 'GDPR', as the new framework for data protection across the European Union (EU), doctors will need to review how they collect and share personal data to ensure they meet the standards. The aim of this article is to raise awareness on the GDPR, and to provide an easy guideline to steer free from legal problems at the time of drafting papers, presenting lectures and sharing personal data and visual media in particular. To do so, we have analysed the most common situations where personal data, and above all visual media, can be collected, giving clear-cut answers and recommendations for all the scenarios.

Perioperative Standard Oral Nutrition Supplements Versus Immunonutrition in Patients Undergoing Colorectal Resection in an Enhanced Recovery (ERAS) Protocol: A Multicenter Randomized Clinical Trial (SONVI Study).

To compare immunonutrition versus standard high calorie nutrition in patients undergoing elective colorectal resection within an Enhanced Recovery After Surgery (ERAS) program.Despite progress in recent years in the surgical management of patients with colorectal cancer (ERAS programs), postoperative complications are frequent. Nutritional supplements enriched with immunonutrients have recently been introduced into clinical practice. However, the extent to which the combination of ERAS protocols and immunonutrition benefits patients undergoing colorectal cancer surgery is unknown.The SONVI study is a prospective, multicenter, randomized trial with 2 parallel treatment groups receiving either the study product (an immune-enhancing feed) or the control supplement (a hypercaloric hypernitrogenous supplement) for 7 days before colorectal resection and 5 days postoperatively.A total of 264 patients were randomized. At baseline, both groups were comparable in regards to age, sex, surgical risk, comorbidity, and analytical and nutritional parameters. The median length of the postoperative hospital stay was 5 days with no differences between the groups. A decrease in the total number of complications was observed in the immunonutrition group compared with the control group, primarily due to a significant decrease in infectious complications (23.8% vs. 10.7%, P = 0.0007). Of the infectious complications, wound infection differed significantly between the groups (16.4% vs. 5.7%, P = 0.0008). Other infectious complications were lower in the immunonutrition group but were not statistically significantly different.The implementation of ERAS protocols including immunonutrient-enriched supplements reduces the complications of patients undergoing colorectal resection.This study is registered with ClinicalTrial.gov: NCT02393976.

Tratamiento de la enfermedad hemorroidal mediante desarterialización y hemorroidopexia. Experiencia de varias unidades especializadas / Treatment of haemorrhoids by transanal haemorrhoidal dearterialization. Experience of several specialized units

INTRODUCCIÓN: Durante varias décadas, las hemorroidectomías de Milligan-Morgan y Ferguson han sido la referencia en el tratamiento de la enfermedad hemorroidal sintomática. Sin embargo las técnicas escisionales llevan asociadas una morbilidad no despreciable. En los últimos años han surgido una serie de técnicas dedicadas a disminuir estos problemas. La desarterialización hemorroidal transanal (THD) guiada por doppler es una de estas técnicas. El objetivo de este estudio es analizar sus resultados según la experiencia de varias unidades especializadas. MÉTODOS: El estudio se realizó en 5 hospitales de la red pública de España. Se analizan y comparan los resultados pre- y posquirúrgicos, así como la homogeneidad interhospitalaria de dicha técnica. Se recogieron de forma prospectiva consecutiva datos de un total de 475 pacientes intervenidos mediante THD, la mayoría con hemorroides grado III(267 casos [56%]). RESULTADOS: La técnica anestésica preferida fue la anestesia raquídea, en un total de 398 casos (81%). Encontramos mejoría global tras la intervención ya que existen diferencias estadísticamente significativas entre síntomas pre- y postoperatorios (p = 0,03). La estancia media fue de 0,4 ± 0,3 días. Los días de analgesia media fueron 8,8 ± 2,7 días (paracetamol y AINE). La tasa acumulada de complicaciones fue del 16%. CONCLUSIONES: La THD es una técnica segura y fácilmente reproducible. Los resultados posquirúrgicos generan una escasa morbilidad, con una estancia hospitalaria muy reducida que permite una rápida reincorporación a la vida laboral, y una tasa de recurrencia baja

INTRODUCTION: Milligan-Morgan and Ferguson haemorrhoidectomy has been the gold standard treatment for symptomatic haemorrhoids for many years. However, escisional techniques are associated with a significant morbidity rate. In recent years, diverse techniques have been described in an attempt to decrease these complications. The guided transanal haemorrhoidal dearterialization THD) doppler is one of these techniques. We report our experience with this new technique. METHODS: We performed a prospective study of 475 patients from 5 hospitals from the National Health System, in Spain. The majority of these patients suffered from third grade haemorrhoids (256 [56%]) and underwent THD. We analyse and compare preoperative and postoperative results as well as the homogeneity of the technique between hospitals. RESULTS: Spinal anaesthesia was the most elected procedure by the anaesthetist (81.0%). Statistically significant differences were found between pre and postoperative symptoms (P = .03), with an overall improvement after surgery. The average hospitalization was 0.4 ± 0.3 days. The mean number of days of oral analgesics was 8.8 ± 2.7 days. The cumulative complication rate is 16%. CONCLUSION: THD is a safe and easily reproducible procedure. Postoperative outcomes demonstrated a low rate of morbidity and recurrence together with early discharge; therefore, a rapid incorporation to daily activities was noted

Treatment of haemorrhoids by transanal haemorrhoidal dearterialization. Experience of several specialized units.

INTRODUCTION: Milligan-Morgan and Ferguson haemorrhoidectomy has been the gold standard treatment for symptomatic haemorrhoids for many years. However, escisional techniques are associated with a significant morbidity rate. In recent years, diverse techniques have been described in an attempt to decrease these complications. The guided transanal haemorrhoidal dearterialization THD) doppler is one of these techniques. We report our experience with this new technique. METHODS: We performed a prospective study of 475 patients from 5 hospitals from the National Health System, in Spain. The majority of these patients suffered from third grade haemorrhoids (256 [56%]) and underwent THD. We analyse and compare preoperative and postoperative results as well as the homogeneity of the technique between hospitals. RESULTS: Spinal anaesthesia was the most elected procedure by the anaesthetist (81.0%). Statistically significant differences were found between pre and postoperative symptoms (P=.03), with an overall improvement after surgery. The average hospitalization was 0.4±0.3 days. The mean number of days of oral analgesics was 8.8±2.7 days. The cumulative complication rate is 16%. CONCLUSION: THD is a safe and easily reproducible procedure. Postoperative outcomes demonstrated a low rate of morbidity and recurrence together with early discharge; therefore, a rapid incorporation to daily activities was noted.

Ertapenem peritoneal fluid concentrations in adult surgical patients.

Ertapenem, a novel carbapenem, is approved for the treatment of mild to severe intra-abdominal infections (IAIs), although its in vivo concentrations in peritoneal fluid are unknown. The purpose of this study was to determine the peritoneal fluid concentration of ertapenem after a single 1 g intravenous dose. After informed consent, 21 patients (9 females and 12 males; mean+/-standard deviation (S.D.) age 50.2+/-17.7 years) requiring intra-abdominal surgery were enrolled. Plasma and peritoneal fluid samples were taken at fixed times during surgery. Drug concentrations were determined by high-performance liquid chromatography (HPLC) with ultraviolet detection. Mean+/-S.D. ertapenem peritoneal fluid concentrations were 64.3+/-23.4 mg/L at 1h and 31.3+/-26.5 mg/L at 3 h after administration. The mean tissue/plasma ratio ranged from 46.7% to 83.1%. The mean peritoneal fluid concentrations were well above the MIC(90) (minimum inhibitory concentration for 90% of the organisms) for susceptible bacteria found in IAIs, especially Escherichia coli, viridans streptococci, Enterobacteriaceae, Klebsiella spp. and Bacteroides fragilis, during the entire sampling time. These pharmacokinetic results support the assumption that ertapenem might be suitable for the treatment of IAIs.