Baseline description of the Spanish Academy of Dermatology infantile haemangioma nationwide prospective cohort. Comparison of patients treated with propranolol in routine clinical practice with previous pivotal clinical trial data. / Descripción basal de la cohorte prospectiva de hemangioma infantil a nivel nacional de la Asociación Española de Dermatología. Comparación de los pacientes tratados con propranolol en la práctica clínica rutinaria y los datos de un ensayo clínico pivotal previo.

BACKGROUND: There are several therapeutic options for infantile haemangiomas (IH). Propranolol is used according to a pivotal trial. We aimed to describe the characteristics of IH in clinical practice, including the therapies used, and to compare the characteristics of patients treated with propranolol with those of the trial to assess its external validity. METHODS: Consecutive patients attending 12 Spanish hospitals from June 2016 to October 2019 were included (n=601). RESULTS: The mean age was 3.9 (SD:1.9) months, with a 2:1 female-to-male ratio. Most IHs were localized (82%, 495), superficial (64%, 383) and located in the face (25%, 157) and trunk (31%, 188). Median size was 17 (IR: 10-30) x 12 (IR: 7-20) mm. Complications were found in 16 (3%) patients. Treatment was initiated for 52% (311). Most patients received timolol (76%, 237); propranolol was reserved for complications or high-risk IHs. Aesthetic impairment was the main reason for starting therapy (64%, 199). Several characteristics of the patients and IHs treated with propranolol are similar to those of the pivotal clinical trial, but 1/3 of IHs did not reach the minimum diameter to meet the inclusion criteria, and important prognostic information was not reported. CONCLUSIONS: As most patients receive treatment for aesthetic impairment, there is a need to better understand the aesthetic results of therapies and to increase evidence on the use of timolol, which is currently the most common therapy. Propranolol is being used in a population generally similar to that of the trial; however, this statement cannot be definitely confirmed.

Prevalencia de estresores académicos en estudiantes de Grado en Enfermería / Prevalence of academic stressors in nursing degree students

OBJETIVO: evaluar los estresores en el entorno académico de los estudiantes de Grado en Enfermería de la Universidad Pública de Navarra. MÉTODO: estudio descriptivo transversal, cuya población fueron 401 estudiantes del Grado en Enfermería de la Universidad Pública de Navarra del curso 2016-2017. Variable dependiente: factores estresores académicos: sobrecarga del estudiante, creencias sobre el rendimiento académico, intervenciones en público, clima social negativo, exámenes, carencia de valor de los contenidos y dificultades de participación. Variables independientes: sociodemográficas, académicas y de estilos de vida. Se enviaron cuestionarios online vía email a todos los estudiantes matriculados, que incluyeron la Escala de Estresores Académicos para la Evaluación de los Estresores Académicos en Estudiantes Universitarios. Se realizaron análisis descriptivo y bivariantes (Chi cuadrado y t de Student). RESULTADOS: muestra final de 86 estudiantes (tasa de respuesta global del 21,4%). La media global para el cuestionario fue de 2,68 puntos sobre 5. Se encontraron diferencias estadísticamente significativas entre la media global del cuestionario y el modo de acceso (p= 0,030), así como con el curso académico (p= 0,031). CONCLUSIONES: aunque se mostró un nivel de afectación por los estresores moderado, el estresor que estos estudiantes consideraron como más perjudicial para su salud fue "deficiencias metodológicas del profesorado"

OBJECTIVE: to evaluate stressors in the academic setting among Nursing Degree students at the Universidad Pública de Navarra. METHOD: a descriptive transversal study, on a population formed by 401 Nursing Degree Students from the 2016-2017 term at the Universidad Pública de Navarra. Dependent variable: academic stressor factors, student overload, beliefs about academic performance, interventions in public, negative social climate, exams, lack of value in contents, and difficulties to participate. Independent variables: sociodemographical, academic and lifestyle. On-line questionnaires were sent through e-mail to all enrolled students; said questionnaires included the Academic Stressor Scale for Evaluation of Academic Stressors in University Students. Descriptive and bivariate analyses were conducted (Square Chi and Student's t). RESULTS: the final sample consisted of 86 students (overall response rate: 21.4%). The overall mean score for the questionnaire was 2.68 out of 5. Statistically significant differences were found between the overall mean score of the questionnaire and the access mode (p= 0.030) as well as with the academic term (p= 0.031). CONCLUSIONS: even though a moderate level of impact by stressors was shown, the students considered that the most harmful stressor for their health was "methodological deficiencies by the teaching staff"

Agreement between semi-automatic radiographic morphometry and Genant semi-quantitative method in the assessment of vertebral fractures.

UNLABELLED: Semi-automatic morphometry is highly reproducible and not time intensive; however, no study has evaluated agreement between semi-automated morphometric methods and the Genant semi-quantitative method performed as a rule by radiologists. Our study shows substantial agreement between both methods; however, semi-automatic morphometry upgrades mild deformities and overestimates the prevalence of fractures. INTRODUCTION: The aim of this study was to evaluate the agreement between radiologists using the Genant semi-quantitative (SQ) method and semi-automated morphometry in the diagnosis of vertebral fractures in post-menopausal women. METHODS: Cross-sectional study was conducted in 2006-2007 in an age-stratified population-based sample of 824 post-menopausal women over the age of 50. From this population two sets of 95 and 50 X-ray were randomly extracted to test inter-rater agreement and agreement between SQ and semi-automated morphometry, and vertebral fractures were classified according to both methods. The Genant method was used to homogenise the diagnosis of fractures. Agreement was evaluated with weighted kappa. We evaluated each vertebral body independently and also the whole vertebral column (T4-L4) classifying women into the worst grade of fracture. For the qualitative interpretation of the agreement, we used the criteria described by Landis and Koch (Biometrics 33:159-174, 1977). RESULTS: The radiologists' agreement was 98.4% (Kappa, 0.75; 95% CI, 0.42-0.89). Agreement between semi-automated morphometry and SQ reached 97.6% and Kappa was 0.86 (95% CI, 0.66-0.94). In the whole evaluation of the spine semi-automated morphometry overestimates, the prevalence of fractures compared with the radiologists were 15.8% of women with fractures and 7.4% of women with moderate-severe fractures by semi-automated morphometry vs. 8.4% and 3.2% by the SQ method. The negative predictive value for MorphoXpress was 99% while the positive was 40%. CONCLUSIONS: Semi-automated morphometry shows high reliability and a substantial agreement with the SQ approach but overestimates the prevalence of fractures. Its role in routine clinical practice is limited because positive results should be reassessed by qualitative or semi-quantitative methods.