The impact of COVID-19 upon student radiographers and clinical training in Latin America.

INTRODUCTION: This study aimed to identify the impact of the COVID-19 pandemic upon radiography education across Latin American countries. METHODS: A survey containing 20 questions was circulated to radiography students, across 13 universities in 11 countries of Latin America using Google Forms. The survey contained open and closed questions. Answers were analysed with descriptive statistics and the methodology of interpretative phenomenological analysis for the open answers. RESULTS: Of the 1310 responses only 23.9% (n = 313) of students reported attending clinical placements and from this cohort only 8.9% (n = 28) became infected with COVID-19. In response to how the pandemic had impacted upon the students' academic progression, the most common topic in the open answers was "Concerns about the lack of clinical training", mentioned by 629 students. Students in middle and later years of their radiography education expressed the greatest concern about future clinical placements. Almost all radiography students (95.2%/n = 1247) indicated that their main concerns regarding COVID-19 infection while undertaking clinical placements was in relation to the risk of infecting their families as most students stated they cohabited with relatives (86.6%/n = 1134). CONCLUSION: Compared to European findings co-habitation trends increased anxiety related to infection and impacted their mental health. Students expressed concern about the quality of education they were receiving during the pandemic and access to resources to facilitate on-line learning was inadequate. Socio-economic and internet connectivity factors specific to Latin America were identified and these issues need to be addressed if on-line education is required in the future. IMPLICATIONS FOR PRACTICE: The COVID-19 pandemic has impacted Latin America and this study identifies the implications for radiography students related to their clinical and academic training and highlights factors which require consideration to support radiography students as the pandemic continues.

Ingesta de polifenoles y riesgo cardiovascular en el ensayo PREDIMED-Plus. Una comparación de diferentes ecuaciones de riesgo / Polyphenol intake and cardiovascular risk in the PREDIMED-Plus trial. A comparison of different risk equations

Introducción y objetivos: La cuantificación del riesgo cardiovascular se basa en puntuaciones como las de Framingham, Framingham-REGICOR, SCORE o Life's Simple 7 (LS7). Los polifenoles pueden proporcionar beneficios al sistema vascular y reducir la respuesta inflamatoria; sin embargo, los estudios clínico-epidemiológicos muestran resultados discordantes. Nuestro objetivo es evaluar la posible asociación entre la ingesta de diferentes clases de polifenoles y las puntuaciones cardiovasculares. Métodos: Estudio transversal sobre 6.633 participantes del estudio PREDIMED-Plus. El contenido de polifenoles se estimó mediante un cuestionario semicuantitativo de frecuencia alimentaria y se ajustó por la ingesta energética total según el método de residuales. La asociación entre la ingesta de polifenoles y el riesgo cardiovascular se evaluó mediante análisis de regresión lineal. Resultados: La ingesta total de polifenoles y flavonoides se asoció directa y significativamente con la escala LS7. Igualmente, los lignanos se asociaron directa y significativamente con las escalas SCORE y LS7; los estilbenos, con la SCORE y los ácidos fenólicos, con las de Framingham y Framingham-REGICOR. La clase «otros polifenoles» se asoció de manera significativa con las escalas de Framingham, SCORE y LS7. En las mujeres, la ingesta de todas las clases de polifenoles, excepto los ácidos fenólicos, mostró una tendencia directa en los resultados de Framingham y Framingham-REGICOR e indirecta con la escala LS7. Conclusiones: Se encontraron asociaciones inversas entre el consumo de la clase «otros polifenoles» y, especialmente en las mujeres, el riesgo cardiovascular estimado. Los resultados fueron similares con las de Framingham, Framingham-REGICOR y LS7 (después de eliminar el componente de dieta) y diferentes con la SCORE, pero los predictores que se incluyen en este son escasos (AU)

Introduction and objectives: Quantification of cardiovascular risk has been based on scores such as Framingham, Framingham-REGICOR, SCORE or Life's Simple 7 (LS7). In vitro, animal, and randomized clinical studies have shown that polyphenols may provide benefits to the vascular system and reduce the inflammatory response. However, some clinical-epidemiological studies have yielded inconsistent results. Our aim was to assess the possible association between intake of the various polyphenol classes and established cardiovascular scores. Methods: This cross-sectional analysis involved 6633 PREDIMED-Plus study participants. Food polyphenol content was estimated by a semiquantitative food frequency questionnaire, adjusted for total energy intake according to the residual method. The association between polyphenol intake and cardiovascular risk was tested using linear regression analyses. Results: Total polyphenol and flavonoid intake were directly and significantly associated only with the LS7 scale. Intake of lignans was directly and significantly associated with SCORE and LS7 scales, stilbene intake with SCORE, and phenolic acid intake with Framingham and Framingham-REGICOR scores. Other polyphenol classes were associated in a protective and significant manner in Framingham, SCORE and LS7 scores. In women, intake of all the polyphenol classes, except phenolic acids, showed a protective trend in the results of the Framingham, Framingham-REGICOR scores and LS7 scale. Conclusions: An inverse association was found between consumption of the ‘other polyphenols’ class and, especially among women, with estimated cardiovascular risk. The results were similar to those of Framingham, Framingham-REGICOR and LS7 (after eliminating the diet component) and differed from those of SCORE, but the predictors included were limited in the latter case (AU)

Non-invasive clinical and microscopic evaluation of the response to treatment with clobetasol cream vs. calcipotriol/betamethasone dipropionate foam in mild to moderate plaque psoriasis: an investigator-initiated, phase IV, unicentric, open, randomized clinical trial.

BACKGROUND: Treatment response for psoriasis is typically evaluated using clinical scores. However, patients can relapse after clinical clearance, suggesting persistent inflammation. Dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) can non-invasively improve treatment response assessment. OBJECTIVES: To compare the clinical and non-invasive microscopic features in a psoriatic target lesion treated with clobetasol cream or calcipotriol/betamethasone dipropionate foam (Cal/BD foam). METHODS: Prospective, unicentric, open, randomized clinical trial comparing clinical data [total clinical score (TCS)] and microscopic data (dermoscopy, RCM and OCT) in psoriasis patients treated with clobetasol or Cal/BD foam. RESULTS: We included 36 adult patients (22 men). At week 4, more patients treated with Cal/BD foam achieved TCS ≤1 than with clobetasol (63.2% vs. 18.8%, P = 0.016). Treatment satisfaction was higher with Cal/BD foam (P < 0.03). Microscopically, Cal/BD foam induced more reduction in epidermal thickness at week 4 (P < 0.049). Dilated horizontal blood vessels were more common with clobetasol than with Cal/BD foam at week 8 (69.2% vs. 31.2%, P = 0.159). If epidermal hyperplasia was noted at baseline, the response was poorer with clobetasol (P = 0.029). LIMITATIONS: Small sample size, open study, imaging sampling bias. CONCLUSION: Cal/BD foam is more effective than clobetasol, has better patient satisfaction and induces greater reduction in the hyperkeratosis/acanthosis, regardless of baseline epidermal hyperplasia.

[Complicated migraine: a study of 7 cases]. / Migraña complicada: estudio de siete casos.

The association between migraine and stroke is well known. It is assumed that 15% of strokes in patients below 45 years are due to migraine. To evaluate the features of this association, we have reviewed seven cases of patients with migraine and established neurological deficits. All patients fulfilled the following criteria: 1) past history of migraine, defined on the basis of the classification by the International Committee for the Classification of Headache; 2) temporal association between a migraine episode, similar to previous ones, and the ischemic episode, and 3) absence of other concomitant diseases that might result in stroke. We evaluated the age at the onset of migraine, its type, familial history of migraine (particularly of migrainous accompaniments), vascular risk factors, mode of onset, and type and duration of neurological deficit. In all cases, cranial CT, EEG, echocardiogram, serologic tests for syphilis, autoantibody investigation, routine laboratory tests and nuclear magnetic resonance (in four patients). In five cases cerebral arteriography was carried out, and arterial occlusion was demonstrated in one. We conclude that, in spite of its low frequency, migraine may result in cerebral ischemic episodes, although the relevant pathogenetic mechanisms are not yet well understood.