Evaluating the Social Media Performance of Hospitals in Spain: A Longitudinal and Comparative Study.

BACKGROUND: Social media is changing the way in which citizens and health professionals communicate. Previous studies have assessed the use of Health 2.0 by hospitals, showing clear evidence of growth in recent years. In order to understand if this happens in Spain, it is necessary to assess the performance of health care institutions on the Internet social media using quantitative indicators. OBJECTIVES: The study aimed to analyze how hospitals in Spain perform on the Internet and social media networks by determining quantitative indicators in 3 different dimensions: presence, use, and impact and assess these indicators on the 3 most commonly used social media - Facebook, Twitter, YouTube. Further, we aimed to find out if there was a difference between private and public hospitals in their use of the aforementioned social networks. METHODS: The evolution of presence, use, and impact metrics is studied over the period 2011- 2015. The population studied accounts for all the hospitals listed in the National Hospitals Catalog (NHC). The percentage of hospitals having Facebook, Twitter, and YouTube profiles has been used to show the presence and evolution of hospitals on social media during this time. Usage was assessed by analyzing the content published on each social network. Impact evaluation was measured by analyzing the trend of subscribers for each social network. Statistical analysis was performed using a lognormal transformation and also using a nonparametric distribution, with the aim of comparing t student and Wilcoxon independence tests for the observed variables. RESULTS: From the 787 hospitals identified, 69.9% (550/787) had an institutional webpage and 34.2% (269/787) had at least one profile in one of the social networks (Facebook, Twitter, and YouTube) in December 2015. Hospitals' Internet presence has increased by more than 450.0% (787/172) and social media presence has increased ten times since 2011. Twitter is the preferred social network for public hospitals, whereas private hospitals showed better performance on Facebook and YouTube. The two-sided Wilcoxon test and t student test at a CI of 95% show that the use of Twitter distribution is higher (P<.001) for private and public hospitals in Spain, whereas other variables show a nonsignificant different distribution. CONCLUSIONS: The Internet presence of Spanish hospitals is high; however, their presence on the 3 main social networks is still not as high compared to that of hospitals in the United States and Western Europe. Public hospitals are found to be more active on Twitter, whereas private hospitals show better performance on Facebook and YouTube. This study suggests that hospitals, both public and private, should devote more effort to and be more aware of social media, with a clear strategy as to how they can foment new relationships with patients and citizens.

Variaciones en los niveles de hemoglobina como factor pronóstico en el reinfarto cardíaco intrahospitalario en pacientes del Servicio de Cardiología del HNAL en el periodo 2010-2012 / Variations in the levels of hemoglobin as a prognostic factor in the hospital cardiac reinfarction in patients of the Cardiology Service at the HNAL in the period 2010-2012

Se diseñó un estudio retrospectivo de casos y controles con el objetivo de determinar si la variación de los niveles de hemoglobina es un factor pronóstico en el reinfarto cardiaco intrahospitalario en pacientes del Servicio de Cardiología del HNAL en el periodo 2010-2012. La muestra de estudio estuvo compuesta de 56 pacientes hospitalizados en el Servicio de Cardiología del HNAL en el periodo 2010 a 2012 con diagnóstico de ingreso de Infarto Agudo de Miocardio, consignado en la historia clínica, con un hemograma basal dentro de las 24 horas desde el inicio de la sintomatología. El diagnóstico de reinfarto se definió según los criterios de GUSTO III. Se calculó la tasa de reinfarto según características clínicas, antecedentes del paciente, y la variación del nivel de hemoglobina. Se consideró el valor de 0.05). En el 62.5 por ciento de los pacientes se registró una disminución de hemoglobina mientras que en el 37.5 por ciento un aumento de hemoglobina; no existió diferencias estadísticamente significativas en la tasa de reinfarto entre quienes aumentó el nivel de hemoglobina (9.5 por ciento; IC 95 por ciento 1,1-30,3 por ciento) y entre quienes disminuyó (20 por ciento; IC 95 por ciento 5,3-34,6 por ciento).

A retrospective case-control study was designed in order to determine whether the change in hemoglobin levels is a prognostic factor in hospital cardiac reinfarction in patients of the cardiology Service HNAL in the period 2010-2012. The study sample consisted of 56 patients hospitalized in the cardiology Department of HNAL in the period 2010-2012 with admission diagnosis of acute myocardial infarction, recorded in the medical record, with a baseline blood count within 24 hours of onset of symptoms. The diagnosis of reinfarction was defined according to criteria GUSTO III. Reinfarction rate was calculated according to clinical characteristics, patient history, and variation in hemoglobin. The value of 0.05) does not exist. In 62.5 per cent of patients had a decrease in hemoglobin while 37.5 per cent increased hemoglobin; there is no significant difference in the rate of reinfarction among those who increased hemoglobin level (9.5 per cent; CI 95 per cent 1.1 to 30.3 per cent) and those who declined (20 per cent; CI 95 per cent 5.3 to 34.6 per cent).

Natalizumab y reducción de los niveles de proteínas carboniladas en pacientes con esclerosis múltiple / Natalizumab and reduction of carbonylated proteins in patients with multiple sclerosis

Introducción. Es conocida la especial sensibilidad del sistema nervioso central al daño oxidativo, así como la relación entre éste y la respuesta inflamatoria. Recientes estudios han mostrado que el estrés oxidativo está presente en la instauración y evolución de la esclerosis múltiple (EM). Uno de los más recientes tratamientos en este proceso es el natalizumab,un anticuerpo monoclonal. Objetivo. Evaluar si el efecto terapéutico del natalizumab se asocia con la gravedad de la enfermedad y el daño oxidativo. Pacientes y métodos. Se reclutó para el estudio a 20 pacientes con EM remitente recurrente (EMRR) incluidos en terapia con natalizumab y distribuidos según la Expanded Disability Status Scale (EDSS) en dos grupos: EMRR-1 (EDSS < 5) yEMRR-2 (EDSS ≥ 5). Se obtuvieron muestras sanguíneas para un estudio del perfil oxidativo.Resultados. Los datos mostraron un descenso en las proteínas carboniladas tras el tratamiento con natalizumab. La reducciónde daño oxidativo valorada como oxidación de proteínas es significativa entre la situación previa del paciente (basal) y tras 14 meses de tratamiento. El decremento más significativo coincidió con los pacientes de mayor gravedad en el proceso. Si bien no ha sido posible establecer una correlación, la significación estadística es mayor para pacientes del grupo EMRR-2 tratados con natalizumab. Por su parte, los sistemas antioxidantes no mostraron cambios estadísticamentesignificativos. Conclusión. El natalizumab induce una reducción en los niveles de proteínas carboniladas (AU)

Introduction. The sensitivity of the central nervous system to oxidative damage and its relationship with inflammatory response are well known. Recent studies have shown that oxidative stress is present in the establishment and developmentof multiple sclerosis (MS). One of the most recent treatments in this process is natalizumab, a monoclonal antibody. Aim. To evaluate whether the therapeutic effect of natalizumab is associated with the severity of the disease and the oxidative damage. Patients and methods. Researchers recruited twenty patients with relapsing-remitting MS (RRMS) undergoing therapy with natalizumab and distributed, according to the Expanded Disability Status Scale (EDSS), in two groups: RRMS-1 (EDSS< 5) and RRMS-2 (EDSS ≥ 5). Blood samples were taken for an oxidative profile study. Results. Data showed a decrease in carbonylated proteins following treatment with natalizumab. The reduction in oxidative damage rated as protein oxidation is significant between the previous (baseline) situation of the patient and after 14 months’ treatment. The most significant decrease coincided with the patients with the highest levels of severity in the process.Although it has not been possible to establish a correlation, the statistical significance is higher for patients in the RRMS-2 group treated with natalizumab. The antioxidant systems, on the other hand, did not display any tatistically significant changes.Conclusions. Natalizumab brings about a reduction in carbonylated protein levels (AU)

Comparison of melatonin, vitamin E and L-carnitine in the treatment of neuro- and hepatotoxicity induced by thioacetamide.

This study was designed to evaluate and compare the effect of melatonin, vitamin E and L-carnitine on brain and liver oxidative stress and liver damage. Oxidative stress and hepatic failure were produced by a single dose of thioacetamide (TAA) (150 mg kg(-1)) in Wistar rats. A dose of either melatonin (3 mg kg(-1)) vitamin E (20 mg kg(-1) ) or L-carnitine (100 mg kg(-1)) was used. Blood samples were taken from the neck vasculature in order to determine ammonium, blood urea nitrogen (BUN) and liver enzymes. Lipid peroxidation products, glutathione (GSH) content and antioxidative enzymes were determined in cerebral and hepatic homogenates. The results showed a decrease in BUN and in the antioxidant enzymes activities and GSH in the brain and liver. Likewise, TAA induced significant enhancement of lipid peroxidation products levels in both liver and brain, as well as in ammonia values. Melatonin, vitamin E and L-carnitine, although melatonin more significantly, decreased the intensity of the changes produced by the administration of TAA alone. Furthermore melatonin combined with TAA, decreased the ammonia levels and increased the BUN values compared with TAA animals. Also it was more effective than vitamin E or L-carnitine in these actions. These data show the protective effect of these agents, especially melatonin, against oxidative stress and hepatic damage present in fulminant hepatic failure.

Hepato- and neurotoxicity induced by thioacetamide: protective effects of melatonin and dimethylsulfoxide.

The effects of melatonin and dimethylsulfoxide (DMSO) on liver and brain oxidative stress, hepatic failure and blood urea nitrogen (BUN) level changes produced by a single dose of thioacetamide (TAA) in Wistar rats were studies. A dose of either melatonin (3 mg kg(-1)day(-1)) or DMSO (2 g kg(-1)day(-1)) was injected for 3 days before and for 2 days after the administration of TAA (150 mg kg(-1) i.p.). Blood samples were taken from the neck vascular in order to determine ammonium, BUN and liver enzymes. We estimated lipid peroxidation products, reduced glutathione (GSH) content and catalase activity in liver and brain homogenates. TAA caused significant increases in ammonium and in the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) enzymes, while it decreased BUN values. TAA also increased lipid peroxidation product levels, but reduced GSH content and catalase activity in the liver and brain. Both melatonin and DMSO, although melatonin more significantly, decreased the intensity of the changes produced by the administration of TAA alone. Furthermore, melatonin alone or combined with TAA increased the BUN levels and decreased the ammonia values compared with control animals. These results support the antioxidative and neuro-/hepato-protective action of melatonin and a lesser action of DMSO. Likewise, these data seem to support the hypothesis of an effect of melatonin on urea synthesis.

National cross sectional study of views on sexual violence and risk of HIV infection and AIDS among South African school pupils.

OBJECTIVE: To investigate the views of school pupils on sexual violence and on the risk of HIV infection and AIDS and their experiences of sexual violence. DESIGN: National cross sectional study. SETTING: 5162 classes in 1418 South African schools. PARTICIPANTS: 269,705 school pupils aged 10-19 years in grades 6-11. MAIN OUTCOME MEASURE: Answers to questions about sexual violence and about the risk of HIV infection and AIDS. RESULTS: Misconceptions about sexual violence were common among both sexes, but more females held views that would put them at high risk of HIV infection. One third of the respondents thought they might be HIV positive. This was associated with misconceptions about sexual violence and about the risk of HIV infection and AIDS. Around 11% of males and 4% of females claimed to have forced someone else to have sex; 66% of these males and 71% of these females had themselves been forced to have sex. A history of forced sex was a powerful determinant of views on sexual violence and risk of HIV infection. CONCLUSIONS: The views of South African youth on sexual violence and on the risk of HIV infection and AIDS were compatible with acceptance of sexual coercion and "adaptive" attitudes to survival in a violent society. Views differed little between the sexes.

Protective effect of melatonin on 3-nitropropionic acid-induced oxidative stress in synaptosomes in an animal model of Huntington's disease.

The effect of melatonin (1 mg/kg BW i.p./day) on the oxidative changes produced by 3-nitropropionic acid (20 mg/kg BW/day for 4 days) in rat striatal and cortical synaptosomes was investigated. The effects of 3-nitropropionic acid were evaluated as changes in the quantity of lipid peroxidation products, protein carbonyl groups and superoxide dismutase and succinate dehydrogenase activities. 3-Nitropropionic acid caused a rise in lipid peroxidation levels and protein carbonyls content whereas it induced a reduction in the activity of succinate dehydrogenase and triggered an enhancement in superoxide dismutase activity. These changes were prevented by previous administration of melatonin. Our results reveal: (i) 3-nitropropionic acid induces a status of oxidative stress in some brain regions of the Wistar rat; (ii) melatonin prevents the deleterious effects induced by the acid. In conclusion, the results show the ability of melatonin to modify the neural response to 3-nitropropionic acid with the protective mechanism likely involving the antioxidative processes of melatonin.

Effect of glucocorticoids on 3-nitropropionic acid-induced oxidative stress in synaptosomes.

The present study with rat striatal and cortical synaptosomes evaluated the effect of dexamethasone (300 microg/kg i.p./day) with and without simultaneous adrenalectomy on the oxidative stress induced by 3-nitropropionic acid (20 mg/kg/day for 4 days). Adrenalectomy enhanced the oxidative stress induced by 3-nitropropionic acid. These changes were prevented by previous and simultaneous administration of dexamethasone. Adrenalectomy alone induced oxidative stress with decreases in succinate dehydrogenase activity. Our results revealed that adrenal glucocorticoids, and especially dexamethasone (synthetic glucocorticoid), have a protective effect against oxidative stress induced by 3-nitropropionic acid in some brain regions of the Wistar rat.

Doença de Coats: diagnóstico e tratamento / Coat's disease: diagnosis and treatment

A Retinopatia de Coats é sempre um tema interessante pelos complexos problemas diagnósticos. Os A.A. apresentam seis casos, cinco com estágio avançado e um em estágio precoce. Este último foi tratado com êxito pela fotocoagulaçäo