Efficacy of transcutaneous perineal electrostimulation versus intracavitary anal electrostimulation in the treatment of urinary incontinence after a radical prostatectomy: Randomized controlled trial.

AIM: To compare the efficacy of the treatment with transcutaneous perineal electrostimulation versus intracavitary electrostimulation to reduce the frequency of urinary incontinence after radical prostatectomy and the impact on the quality of life (QoL). METHODS: This single-blind equivalence-randomized controlled trial equally (1:1) randomly allocated men with urinary incontinence post radical prostatectomy into surface electrodes perineal group (intervention group, IG) and intra-anal probe group (control group, CG). Outcomes included changes in the 24h-Pad Test (main variable), and ICIQ-SF (International Consultation on Incontinence Questionnaire Short-Form), SF-12 (Short Form Health Survey), and I-QOL (incontinence quality of life questionnaire) questionnaires. Clinical data were collected at baseline, 6 and 10 weeks. For the comparisons between variables, χ2 test and Student's t test were used. Equivalence was analyzed by estimating the mean change (90% confidence interval) of urinary incontinence based on the Pad Test. The analysis was performed for the per-protocol and the intention-to-treat populations. Statistical significance level was set at p < 0.05. RESULTS: Seventy patients were included, mean age 62.8 (SD 9.4) years. Mean baseline 24h-Pad Test was 328.3 g (SD 426.1) and a significant decrease (p < 0.001) in the grams of urine loss at 5 weeks (159.1 g in the IG and 121.7 g in the CG), and at 10 weeks of treatment (248.5 g in the IG and 235.8 g in the CG) was observed. However, the final difference in the grams of urine loss between both treatments showed the absence of statistical significance (p = 0.874). In both groups, the ICIQ-SF, I-QOL, and SF-12 questionnaires revealed a significant improvement in QoL. CONCLUSION: Surface and intra-anal electrostimulation treatments reduced significantly losses of urine, but differences in grams of urine loss throughout the therapy between groups were not significant, suggesting that the efficacy of the two treatments is not statistically different. Nonetheless, the improvement observed in both groups was statistically significant and clinically relevant.

Benefits of a Pediatric Antimicrobial Stewardship Program in Antimicrobial Use and Quality of Prescriptions in a Referral Children's Hospital.

OBJECTIVES: To evaluate the results of the first 24 months of a postprescription review with feedback-based antimicrobial stewardship program in a European referral children's hospital. STUDY DESIGN: We performed a pre-post study comparing antimicrobial use between the control (2015-2016) and the intervention periods (2017-2018) expressed in days of therapy/100 days present. Quality of prescriptions was evaluated by quarterly cross-sectional point-prevalence surveys. Length of stay, readmission rates, in-hospital mortality rates, cost of systemic antimicrobial agents, and antimicrobial resistance rates were included as complementary outcomes. RESULTS: Total antimicrobial use and antibacterial use significantly decreased during the intervention period (P = .002 and P = .001 respectively), and total antifungal use remained stable. A significant decline in parenteral antimicrobial use was also observed (P < .001). In 8 quarterly point-prevalence surveys (938 prescriptions evaluated), the mean prevalence of use of any antimicrobial among inpatients was 39%. An increasing trend in the rate of optimal prescriptions was observed after the first point-prevalence survey (P = .0898). Nonoptimal prescriptions were more common in surgical than in medical departments, in antibacterial prescriptions with prophylactic intention, and in empirical more than in targeted treatments. No significant differences were observed in terms of mortality or readmission rates. Only minor changes in antimicrobial resistance rates were noted. CONCLUSIONS: Our antimicrobial stewardship program safely decreased antimicrobial use and expenditure, and a trend toward improvement in quality of prescription was also observed.

[Cooking Skills and Consumption of Ready Meal in University Students of Barcelona, Spain]. / Competencias culinarias y consumo de alimentos procesados o preparados en estudiantes universitarios de Barcelona.

OBJECTIVE: Confidence in cooking skills is relevant in health. The objective was to study the status of cooking skills and consumption of ready meal among university students in the city of Barcelona, assessing their association with sociodemographic variables and confidence in some culinary skills and knowing how to cook. METHODS: Cross-sectional study, carried out during the 2014-2015 academic year, 525 students (81.3% women, median age 21 years) using an on-line questionnaire. Bivariate and multivariate analyses were performed; odds ratios and 95% confidence intervals were estimated. RESULTS: Between 53% and 89% of the students reported feeling very confident in 10 of the 18 cooking skills. No statistically significant differences were observed by sex, and between 62% and 86% of those over 21 years expressed great confidence in 9 competitions. The consumption of ready meal was prevalent (49.4%) and associated with age (OR=0.95 95% CI: 0.91-0.99), gender (male, OR=1.98 95% CI: 1.23-3.18) and not knowing how to cook (OR=2.25 95% CI: 1.10-4.60). In students who knew how to cook, eating ready meal was associated with gender (male, OR =1.67 95% CI: 1.00 to 2.77) and no longer feel confident in preparing more than one food at one time (OR = 1.73 95% CI: 1.58 to 2.60). CONCLUSIONS: Students at a university in Barcelona have a level in cooking skills which could be improved, and consume ready meals usually.

OBJETIVO: Las competencias culinarias pueden tener relevancia en la salud. El objetivo del estudio fue conocer el estado de las competencias culinarias y el consumo de alimentos procesados o preparados en estudiantes universitarios en Barcelona así como su asociación con variables sociodemográficas y la confianza en algunas competencias culinarias y el saber cocinar. METODOS: Diseño transversal, durante el curso 2014-2015, con 525 estudiantes (81,3% mujeres, edad mediana 21 años), mediante un cuestionario en línea. Se realizaron análisis bivariados y multivariados con modelos de regresión logística. Como medida de asociación se estimó la odds ratio y su intervalo de confianza del 95%. RESULTADOS: Entre el 53% y el 89% de los estudiantes declararon sentirse muy confiados en 10 de las 18 competencias culinarias estudiadas. No se observaron diferencias estadísticamente significativas por sexo y entre el 62% y el 86% de las personas mayores de 21 años expresaron mucha confianza en 9 competencias. La prevalencia del consumo de alimentos procesados o preparados fue del 49,4% y se asoció a la edad (OR=0,95 IC95%: 0,91-0,99), al sexo (hombre, OR=1,98 IC95%: 1,23-3,18) y a no saber cocinar (OR=2,25 IC95%: 1,10-4,60). Entre quienes sabían cocinar este consumo se asoció al sexo (hombre, OR=1,67 IC95%: 1,00-2,77) y a no tener confianza en preparar más de un alimento al mismo tiempo (OR=1,73 IC95%: 1,58-2,60). CONCLUSIONES: Los estudiantes universitarios de Barcelona tienen competencias culinarias mejorables y consumen alimentos procesados o preparados habitualmente.

[Development of a structural capacity index for oncological surgery in acute hospitals]. / Desarrollo de un índice de capacidad estructural para hospitales de agudos con cirugía oncológica.

INTRODUCTION: The study of the impact of structure on outcomes has mainly been focused on the number procedures. The aim of our study was to develop a structure capacity index for hospitals for oncological surgery. METHODS: Cross-sectional study by means of a questionnaire related to the structural characteristics of hospitals that had performed gastrointestinal oncological surgery in Catalonia during 2004. Variables were considered for the index according to their measurement and conceptual properties. RESULTS: A response was obtained from 37 out of 48 hospitals. Variables with good conceptual and measurement properties (Cronbach alpha 0.92 and Item-Total correlation >0.7) were included in the index. These variables were related to teaching, management and technology. CONCLUSIONS: The index has acceptable levels of reliability and validity, and can be a useful tool to classify hospitals according to their technological characteristics and management strategies.

[Trends of HIV mother-to-child transmission in Catalonia, Spain, between 1987 and 2003]. / Evolución de la transmisión vertical del VIH en Cataluña durante el período 1987-2003.

BACKGROUND AND OBJECTIVE: To describe and to analyze the evolution of the mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV), the clinical and epidemiological characteristics and the use of antiretrovirals (ARV) in the HIV infected pregnant women and their new-borns alive between 1987 and 2003 in Catalonia. MATERIAL AND METHOD: The available clinical-epidemiological and treatment data were obtained from 4 reference hospitals that take care of most of the children born to HIV infected mothers in Catalonia. Two of the hospitals had a data base designed to the follow up of their patients, whereas in the other 2 data were gathered by reviewing clinical registries. For the analysis, 3 periods, based on the recommendations of treatment ARV during pregnancy, were settled down: 1987-1993; 1994-1996, and 1997-2003. RESULTS: 1,105 mother-infant pairs were studied. HIV MTCT was reduced from 20.4% to 3.5% from first to third period of study (p < 0.001). The median age of the mothers increased from 24.6 to 30.5 years of age (p < 0.001). The proportion of women infected by sexual transmission increased from 17.2% to 58.8% (p < 0.001), whereas that of parenteral transmission decreased from the 79.2% to 43.5% (p < 0.001). In the last period, 74.1% of mother-child pairs received complete ARV prophylaxis regimens and 21.6% partial ones. The rate of elective caesarean-section went up from 32.2% to 58.2% (p < 0.001). CONCLUSIONS: The rates of MTCT in our setting have followed the same trend as in other countries of our surroundings. The observed changes reflect the variations in the characteristics of the epidemic in the general population. The implementation of the recommendations on ARV prophylaxis has begun early and it has extended progressively without getting to be total. Additional strategies for the universal coverage of the screening test during pregnancy are still needed.