ABSTRACT
INTRODUCCIÓN: La aplicación WhatsApp es la herramienta preferida de los pacientes para realizar teleconsultas. Sin embargo, la falta de un claro marco de legalidad o un mal uso puede tener repercusiones emocionales negativas en el dermatólogo. OBJETIVOS: Determinar las características básicas de la consulta realizada por WhatsApp, cuantificar objetivamente la repercusión en tiempo consumido y evaluar las consecuencias emocionales en el dermatólogo. MATERIAL Y MÉTODO: Es un estudio descriptivo, observacional, transversal y retrospectivo elaborado a partir de la información recogida en una encuesta de opinión online, compuesta por 43 preguntas, que fue remitida a los 275 dermatólogos de la Sección Valenciana de la Academia Española de Dermatología y Venereología. RESULTADOS: La encuesta fue contestada por 128 dermatólogos, el 46,6% de los encuestados. Todos los participantes manifestaron utilizar WhatsApp o Telegram. El 93% recibía consultas por esta vía, y de estos, un 88,3% admitió responder a este tipo de mensajes. El 74,1% de las consultas fueron sobre enfermedad inflamatoria aguda en las que se suele aconsejar un tratamiento farmacológico. Casi un tercio de las mismas necesitó de una visita presencial. La confianza con el dermatólogo, la comodidad y la rapidez de respuesta fueron las motivaciones para este tipo de consulta. El 31% de los dermatólogos participantes reconoció que este tipo de consultas repercute negativamente en su estado de ánimo y el 82,3% preferiría dejar de recibirlas. CONCLUSIONES: Es necesario regular este tipo de consulta. Hay muy pocos estudios sobre este ámbito y quedan abiertas muchas cuestiones todavía por esclarecer
BACKGROUND: WhatsApp is a preferred method of remote consultation for patients. However, the lack a legal framework for this type of patient-physician contact or the inappropriate use of the application can have negative emotional effects on the dermatologist. OBJECTIVES: To determine the basic characteristics of WhatsApp consultations, quantify the time spent on them, and assess the emotional impact on the dermatologist. Material and methods Retrospective, descriptive, observational, cross-sectional study of responses to a 43-item online survey sent to 275 dermatologists who were members of the Spanish Academy of Dermatology and Venereology (AEDV) working in the Spanish autonomous community of Valencia. RESULTS: A total of 128 dermatologists (46.6%) responded. All reported that they used WhatsApp or Telegram; 93% received consultations by this means and 88.3% responded to the messages. Acute inflammatory conditions, usually requiring medication, accounted for 74.1% of the messages. Nearly a third of the consultations required a visit with the dermatologist.The respondents thought that patients used this means of consultation because they felt at ease with the dermatologist, the app was a convenient tool, and they received quick responses. Thirty-one percent of the dermatologists reported that WhatsApp consultations had a negative emotional impact on them, and 82.3% would prefer not to receive these messages. CONCLUSIONS: WhatsApp consultation should be regulated. Few studies have looked at this type of consultation and many questions remain to be answered
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Teledermatology , Online Social Networking , Remote Consultation/instrumentation , Remote Consultation/methods , Surveys and Questionnaires , Cross-Sectional Studies , Retrospective Studies , SpainABSTRACT
BACKGROUND: WhatsApp is a preferred method of remote consultation for patients. However, the lack a legal framework for this type of patient-physician contact or the inappropriate use of the application can have negative emotional effects on the dermatologist. OBJECTIVES: To determine the basic characteristics of WhatsApp consultations, quantify the time spent on them, and assess the emotional impact on the dermatologist. Material and methods Retrospective, descriptive, observational, cross-sectional study of responses to a 43-item online survey sent to 275 dermatologists who were members of the Spanish Academy of Dermatology and Venereology (AEDV) working in the Spanish autonomous community of Valencia. RESULTS: A total of 128 dermatologists (46.6%) responded. All reported that they used WhatsApp or Telegram; 93% received consultations by this means and 88.3% responded to the messages. Acute inflammatory conditions, usually requiring medication, accounted for 74.1% of the messages. Nearly a third of the consultations required a visit with the dermatologist.The respondents thought that patients used this means of consultation because they felt at ease with the dermatologist, the app was a convenient tool, and they received quick responses. Thirty-one percent of the dermatologists reported that WhatsApp consultations had a negative emotional impact on them, and 82.3% would prefer not to receive these messages. CONCLUSIONS: WhatsApp consultation should be regulated. Few studies have looked at this type of consultation and many questions remain to be answered.
Subject(s)
Remote Consultation , Venereology , Cross-Sectional Studies , Dermatologists , Humans , Retrospective StudiesABSTRACT
Pregnancy-associated breast cancer is the most common solid tumor in pregnancy after cervical carcinoma but still has a low incidence. It has been associated with a poor prognosis; though based on a limited number of retrospective case-control studies, some authors have reported no differences from that of non-pregnant patients. There is no consensus about the treatment; it requires an interdisciplinary approach and it is necessary to balance between the benefit for the mother and risk for the fetus. Each case requires an individual decision taking into account the stage of disease, patient preferences and gestational age. Above chemotherapy, it is only recommended after the first trimester of pregnancy and anthracyclin-based schemes have the higher evidence, but taxanes are also considered as an alternative in patients who do not respond to anthracyclines or its use is contraindicated. For the time being, there is a lack of data, and clinical decisions are based on small retrospective cohorts, case-control studies and case reports. We report two cases of patients being diagnosed with breast cancer while being pregnant and treated with surgery and chemotherapy, including anthracyclines, during the second and third trimester of pregnancy. In both reported cases, childbirth was induced before the 37th week of gestation and only one presented low birth weight with no more complications. The echocardiogram monitorization showed normal cardiac function in mothers and fetus.
Subject(s)
Breast Neoplasms/drug therapy , Carcinoma, Ductal, Breast/drug therapy , Pregnancy Complications, Neoplastic/drug therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/complications , Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/complications , Carcinoma, Ductal, Breast/surgery , Female , Humans , Pregnancy , Pregnancy OutcomeABSTRACT
Sufficient nutrient application is one of the most important factors in producing quality citrus fruits. One of the main guides in planning citrus fertilizer programs is by directly monitoring the plant nutrient content. However, this requires analysis of a large number of leaf samples using expensive and time-consuming chemical techniques. Over the last 5 years, it has been demonstrated that it is possible to quantitatively estimate certain nutritional elements in citrus leaves by using the spectral reflectance values, obtained by using near infrared reflectance spectroscopy (NIRS). This technique is rapid, non-destructive, cost-effective and environmentally friendly. Therefore, the estimation of macro and micronutrients in citrus leaves by this method would be beneficial in identifying the mineral status of the trees. However, to be used effectively NIRS must be evaluated against the standard techniques across different cultivars. In this study, NIRS spectral analysis, and subsequent nutrient estimations for N, K, Ca, Mg, B, Fe, Cu, Mn, and Zn concentration, were performed using 217 leaf samples from different citrus trees species. Partial least square regression and different pre-processing signal treatments were used to generate the best estimation against the current best practice techniques. It was verified a high proficiency in the estimation of N (Rv = 0.99) and Ca (Rv = 0.98) as well as achieving acceptable estimation for K, Mg, Fe, and Zn. However, no successful calibrations were obtained for the estimation of B, Cu, and Mn.
ABSTRACT
Jatropha curcas L. is a biodiesel crop that is resistant to drought stress. However, the salt tolerance of this plant has not yet been studied. To address this question, J. curcas seedlings were grown in a fertilised substrate to evaluate the effects of salinity stress on growth, leaf water relation and organic solutes, leaf and root mineral concentrations, chlorophyll fluorescence parameters, and carbohydrate concentration. The experiment consisted of six treatments with different concentrations of NaCl in the irrigation water: 0 (control), 30, 60, 90, 120 and 150 mM. The total biomass exhibited a salt-induced decrease in the 60 mM or higher NaCl concentrations. The Cl(r) concentration was higher than the Na(+) concentration in all of the plant tissues. The water potential and relative water content of the leaves were not affected by any of the salt treatments. However, salinity induced a decline in the leaf K(+) concentration, together with a significant enhancement in the leaf P, S, Fe, Zn, Mn and Cu levels. The net assimilation of CO2 also decreased with the salt treatment, due in part to non-stomatal limitation from the increase in C(a)/C(i) and a decrease in the maximum quantum efficiency (F(v)/F(m)) of photosystem II and soil plant analysis development (SPAD) units. This work suggests that J. curcas seedlings exhibit a moderate tolerance to salinity, as the plants were able to tolerate up to 4 dS m(-1) (EC water irrigation; 30 mM NaCl). The negative influences of salinity in this crop are mainly due to Cl(r) and/or Na(+) toxicity and to a nutritional imbalance caused by an increase in the Na(+)/K(+) ratio. The osmotic effect of salinity in this species is negligible, perhaps due to its strong control of leaf transpiration, which reduces water loss.
