Paternal safety of the use of mycophenolic acid in kidney transplant recipients. Results of the EMVARON study.

BACKGROUND: The use of mycophenolic acid (MPA) in women during pregnancy causes an increase in miscarriages and birth defects with a typical embryopathy profile. Although epidemiological data does not suggest a greater risk among the offspring of male kidney transplant recipients, the European Medicines Agency and The Spanish Agency of Medicines and Medical Devices introduced the recommendation of using contraceptive methods. METHODS: We conducted a national retrospective study in 15 Spanish Kidney Transplant Centers to evaluate the frequency of miscarriages and birth defects between the offspring from male kidney transplants recipients. We included 151 males who had fathered 239 offspring, 225 under MPA and 14 without MPA. RESULTS: The results of our study showed an incidence of miscarriages in the MPA group of 9.8%, and of birth defects of 4%. CONCLUSIONS: We observed an incidence of miscarriages between the offspring fathered by kidney transplant males under MPA lower than the general population. The incidence of birth defects was similar to the incidence described in other studies and the fact that we did not find the typical embryopathy profile makes it difficult to associate them to the use of MPA. Because of that, we urge the European and Spanish Agencies to reconsider their recommendations for males.

Prevalence of burnout in mental health nurses and related factors: a systematic review and meta-analysis.

The aim of this study was to determine the prevalence of burnout in mental health nurses and to identify its predictors. A systematic review was conducted of studies published in the following databases: CINAHL, Dialnet, LILACS, ProQuest, PsycINFO, PubMed, SciELO, and Scopus. The search equation used was "Nurs * AND Burnout AND mental health". Subsequently, three fixed-effects meta-analyses were performed, one for each dimension of burnout, to calculate its prevalence and the corresponding confidence intervals. The data were analysed using StatsDirect meta-analysis software. Eleven studies were finally included (n = 11). In most cases, the literature informs about moderate levels of emotional exhaustion, depersonalization, and personal accomplishment. The studies inform that variables such as work overload, work-related stress, professional seniority, male gender, being single, and aggression at work, among other factors, contribute to burnout development. The meta-analytic prevalence estimations of burnout with a sample of n = 868 mental health nurses are 25% for high emotional exhaustion, 15% for depersonalization, and 22% for low personal accomplishment. From a workforce development and safety perspective, it is important for managers to address the emotional exhaustion and low personal accomplishment aspects of burnout reported in the workplace by mental health nurses.

Administration of mycophenolic acid is not associated with malformations in descendants from kidney transplanted males.

BACKGROUND: In pregnant women, the use of Mycophenolic acid (MPA) is associated with teratogenicity. Recently, the European Medicines Agency (EMEA) and the Spanish Agency of Medicine and Sanitary Products (AEMPS) warned about the potential teratogenic effects of MPA. These adverse events may occur even in children from males on treatment with MPA. However, evidence of malformations in offsprings of male kidney transplanted patients (KT) exposed to MPA is limited. Thus, the present study aimed to evaluate the incidence of offspring malformations in children of renal transplanted males under MPA. MATERIALS AND METHODS: We conducted a retrospective study in which we evaluated the incidence of malformations in descendants from male recipients that were exposed or not to MPA before and at the time of conception. Two groups of patients were evaluated. Those exposed to MPA (MPA group, n = 20) and the non-MPA group (n = 13) that included patients that did not receive AZA (n = 5) and eight that did receive AZA (n = 8) at the time of conception. RESULTS: A total of forty-nine post-transplant conceptions were identified from 33 different renal transplanted males. MPA was used as the immunosuppressant in 28 of the conceptions. Males from the non-MPA group fathered the other 21 children. Median time from grafting to conception was 6.1 (IQR 2.4-11.1) years, and it was similar between groups. There were eight miscarriage episodes, 2 in the non-MPA group and 6 in the MPA group although differences were not reached. After that, all patients had children without problems. No malformations were detected in any of the 49 regardless whether they were exposed or not to MPA. CONCLUSIONS: No evidence of MPA-associated malformations was observed in descendants of kidney transplanted males on treatment with MPA. Further research is warranted to confirm our findings to properly advice transplanted males keen to procreate.

La medicina de familia sigue siendo una especialidad poco atractiva para los estudiantes de medicina / The family medicine continues being a not much attractive speciality for the students of medicine

No disponible

El pterigio una patología relevante en la población del valle de San Diego de Ubate / The petrigio, a relevant pathology in San Diego de Ubate people

Esta investigación descriptiva buscaba conocer la relación de la aparición del pterigio, en diferentes poblaciones según su edad, género, ocupación y zona de permanencia, de los pobladores del Valle de San Diego de Ubaté, durante el periodo comprendido entre julio de 2005 y enero de 2006. La muestra del presente estudio fue de 897 pacientes que asistieron a la consulta de optometría y oftalmología del Hospital El Salvador de Ubaté. Para los efectos de esta investigación, el método de recolección de datos fue el de recopilación de historias clínicas, que consistió en la aplicación de un instrumento o formulario impreso, orientado a recabar la información sobre el problema de estudio. Como resultados, se observó que la prevalencia de pterigio, fue del 40.31 por ciento en el grupo de edad entre 20 – 40 años, del 61.47 por ciento en el grupo de edad entre 41 – 65 años y del 29.22 por ciento a los mayores de 65 años. Por género la prevalencia fue del 83. 64 por ciento en mujeres y del 47.36 por ciento en hombres. Según la ocupación, la presencia de pterigio fue del 42.33 por ciento en personas dedicadas al hogar, el 35.27 por ciento a la agricultura y 24.18 por ciento a la minería. En los municipios que se presentó cuadro de pterigio fueron respectivamente 30.24 por ciento Ubaté, 20.16 por ciento Fuquene, 16.13 por ciento Susa, compartiendo el 11.8 por ciento Cucunuba, Guachetá, Carmen de Carupa, 9.7 por ciento Tausa, 8.6 por ciento Simijaca, compartiendo el 7.5 por ciento Suatatausa y Lenguazaque.

This descriptive research intends to know the reasonof the presence of pterigio in different population,regarding age, gender, occupation and permanencezone of Valle de San Diego de Ubate populationfrom July 2005 to January 2006. The sample was897 patients who attended optometry andophthalmology consultation in the El Salvador deUbate Hospital. The research methodology wasthrough clinical records collection, applying aprinted survey to find information about the specificproblem. As a result, pterigio had a presence of 40.31 percent in the group of 20-40 year old population;61.47 percent in 41-65 year old group and 29.22 percent in over65 year old people. By gender, the prevalence was 83.64 percent in women and 47.36 in men. Regardingoccupation, the presence of pterigio was 42.33 percent inpeople related to housework, 35.27 percent in agricultureand 24.18 percent in mining. Finally, the towns presentedthe following percentage: 30.24 percent in Ubaté, 20.16 percentin Fuquene, 16.13 percent in Susa, 11.8 percent in Cucunuba,Guachetá, and Carmen de Carupa, 9.7 percent in Tausa,8.6 percent in Simijaca, and 7.5 percent in Suatatausa andLenguazaque.