[Pan American Crohn's and Colitis Organization (PANCCO) and the Interamerican Society of Endoscopy (SIED) consensus on endoscopy in inflammatory bowel disease]. / Consenso de endoscopia en enfermedad inflamatoria intestinal de la Organización Panamericana de Crohn y Colitis (PANCCO) y la Sociedad Interamericana de endoscopia (SIED).

INTRODUCTION: Endoscopy plays a fundamental role in inflammatory bowel disease (IBD), and becomes essential in diagnosis, treatment monitoring, and detection and management of complications. MATERIALS AND METHODS: The Pan American Crohn's and Colitis Organization (PANCCO) and the Inter-American Society of Endoscopy (SIED) appointed 22 Latin American experts in IBD to develop a consensus study using the modified Delphi method, based on the best available evidence. A working group of 22 members from 9 countries identified 15 topics and formulated 98 statements, who participated in 2 rounds of voting. It was defined as agreement of ≥80% of experts for each statement. RESULTS: After the voting of all the statements, 8 statements were obtained that did not reach 80% consensus among the participants, so the questions were reconsidered in the Coordinating Committee of the consensus with the participation of the expert reviewers of these questions and 7 final statements were voted again by all the experts in a second round and 1 was eliminated with consensus. After two rounds of voting, the experts reached consensus with literature review with the best available evidence, the most important issues were developed with scientific evidence supporting each of the statements around the topic of endoscopy in IBD. CONCLUSIONS: Consensus statements were developed and based on the best available evidence about endoscopy in inflammatory bowel disease.

Relationship between mastication and malnutrition in community-dwelling older adults: a meta-analysis.

PURPOSE: To determine the relationship between mastication and malnutrition in community-dwelling older adults. RESEARCH STRATEGIES: To establish the eligibility criteria, the acronym PECOS was used: Population: non-institutionalized older adults; Exposure: older adults with malnutrition; Control: older adults without malnutrition; Outcome: masticatory problems in malnourished older adults; Study types: observational studies. SELECTION CRITERIA: It selected studies assessing malnutrition and mastication difficulties in non-institutionalized adults over 60 years old, of both sexes. Mastication and malnutrition were evaluated with questionnaires on self-reported symptoms and clinical and instrumental assessments. There were no restrictions on language, year of publication, or ethnicity. DATA ANALYSIS: The included studies were evaluated for methodological quality with the Joanna Briggs Institute tool for cross-sectional studies. For the cross-sectional studies included, the odds ratio (OR) was calculated with 95% confidence intervals. RESULTS: After searching the databases, 692 references were retrieved, with three studies selected for quantitative and qualitative analysis. The values obtained in the meta-analysis for association show that malnutrition and mastication difficulties were 2.21 times as likely to occur (OR = 2.21; 95%CI = 0.93 - 5.26; I2 = 94%) as individuals without malnutrition (p < 0.001). The assessment of the risk of bias presented a high-risk, a moderate-risk, and a low-risk study. The certainty of evidence was rated very low with the GRADE tool. CONCLUSION: Individuals at risk of malnutrition are 2.21 times as likely to have mastication difficulties.

Diagnostic delay in bronchiectasis: an Italian perspective.

It takes ∼3.5 years to reach a diagnosis of bronchiectasis from onset of symptoms: the long patient's journey in Italy https://bit.ly/46XMWAz.

Exploring predictors of dysphagia in survivors of head and neck cancer: A cross-sectional study.

PURPOSE: To evaluate the prevalence of dysphagia in survivors of head and neck cancer (sHNC) and to identify the predictors contributing to the development of dysphagia. METHODS: We enrolled 62 sHNC in a cross-sectional study to check the prevalence of dysphagia in sHNC and to evaluate which factors were influencing the presence of this side effect. Besides dysphagia, sociodemographic and clinical characteristics, oral symptoms, maximal mouth opening (MMO), sleep quality and physical condition were evaluated, and a linear regression analysis was performed to verify which of these outcomes impact dysphagia. RESULTS: Among all the sHNC, 85.5% presented dysphagia. The linear regression analysis confirmed that 44.9% of the variance in dysphagia was determined by coughing, MMO and sleep quality, being MMO the most powerful predictor, followed by coughing and sleep quality. CONCLUSION: Dysphagia affected the great majority of sHNC. Moreover, symptoms as coughing, reduced MMO and sleep disorders may act as predictors contributing to the development of dysphagia. Our results emphasize the importance of an early and proper identification of the symptoms as well as an adequate treatment strategy to address the cluster of symptoms that sHNC undergo.

Double blocking of carbon metabolism causes a large increase of Calvin-Benson cycle compounds in cyanobacteria.

Carbon-flow-regulator A (CfrA) adapts carbon flux to nitrogen conditions in nondiazotrophic cyanobacteria. Under nitrogen deficiency, CfrA leads to the storage of excess carbon, which cannot combine with nitrogen, mainly as glycogen. cfrA overexpression from the arsenite-inducible, nitrogen-independent ParsB promoter allows analysis of the metabolic effects of CfrA accumulation. Considering that the main consequence of cfrA overexpression is glycogen accumulation, we examined carbon distribution in response to cfrA expression in Synechocystis sp. PCC 6803 strains impaired in synthesizing this polymer. We carried out a comparative phenotypic analysis to evaluate cfrA overexpression in the wild-type strain and in a mutant of ADP-glucose pyrophosphorylase (ΔglgC), which is unable to synthesize glycogen. The accumulation of CfrA in the wild-type background caused a photosynthetic readjustment although growth was not affected. However, in a ΔglgC strain, growth decreased depending on CfrA accumulation and photosynthesis was severely affected. An elemental analysis of the H, C, and N content of cells revealed that cfrA expression in the wild-type caused an increase in the C/N ratio, due to decreased nitrogen assimilation. Metabolomic study indicated that these cells store sucrose and glycosylglycerol, in addition to the previously described glycogen accumulation. However, cells deficient in glycogen synthesis accumulated large amounts of Calvin-Benson cycle intermediates as cfrA was expressed. These cells also showed increased levels of some amino acids, mainly alanine, serine, valine, isoleucine, and leucine. The findings suggest that by controlling cfrA expression, in different conditions and strains, we could change the distribution of fixed carbon, with potential biotechnological benefits.

Use of botulinum toxin type A in the prehabilitation of abdominal wall musculature for hernia repair: a consensus proposal.

The prehabilitation of the abdominal wall through the infiltration of botulinum toxin type A, which induces temporary chemical denervation ("chemical component separation") in the lateral abdominal musculature, is a common practice in units specialized in abdominal wall surgery. However, its use for this indication is currently off-label. The main objective of this article is to describe a consensus proposal regarding indications, contraindications, dosages employed, potential side effects, administration method, and measurement of possible outcomes. Additionally, a proposal for an informed consent document endorsed by the Abdominal Wall Section of the Spanish Association of Surgeons is attached.

Description of maternal and neonatal adverse events in pregnant people immunised with COVID-19 vaccines during pregnancy in the CLAP NETWORK of sentinel sites. Nested case-control analysis of the immunization-associated risk: A study protocol.

INTRODUCTION: COVID-19 is associated with higher morbimortality in pregnant people compared with non-pregnant people. At present, the benefits of maternal immunisation are considered to outweigh the risks, and therefore, vaccination is recommended during pregnancy. However, additional information is needed on the safety of the vaccines in this population. METHODS AND ANALYSIS: This a retrospective cohort nested case-control study in pregnant people who attended maternity hospitals from eight Latin American and Caribbean countries. A perinatal electronic clinical history database with neonatal and obstetric information will be used. The proportion of pregnant people immunised with COVID-19 vaccines of the following maternal and neonatal events will be described: preterm infant, small for gestational age, low birth weight, stillbirth, neonatal death, congenital malformations, maternal near miss and maternal death. Moreover, the risk of prematurity, small for gestational age and low birth weight associated with exposure to COVID-19 vaccines will be estimated. Each case will be matched with two groups of three randomly selected controls. Controls will be matched by hospital and mother's age (±3 years) with an additional matching by delivery date and conception time in the first and second control groups, respectively. The estimated required sample size for the main analysis (exposure to any vaccine) concerning 'non-use' is at least 1009 cases (3027 controls) to detect an increased probability of vaccine-associated event risk of 30% and at least 650 cases (1950 controls) to detect 30% protection. Sensitivity and secondary analyses considering country, type of vaccine, exposure windows and completeness of immunisation will be reported. ETHICS: The study protocol was reviewed by the Ethical Review Committee on Research of the Pan American Health Organization. Patient informed consent was waived due to the retrospective design and the utilisation of anonymised data (Ref. No: PAHOERC.0546.01). Results will be disseminated in open access journals.

Efficacy of photobiomodulation therapy combined with mobile health education in patients with head and neck cancer suffering from chronic xerostomia after radiotherapy: protocol for a three-arm, randomised, placebo-controlled, double-blinded study.

INTRODUCTION: The role of photobiomodulation (PBM) therapy for oral tissue damage induced by cancer treatment is currently unclear, and there is low-quality to moderate-quality evidence supporting the use of this approach for treating xerostomia and/or hyposalivation. Consequently, patients with head and neck cancer increasingly turn to basic oral hygiene to alleviate salivary gland dysfunction, and their adherence can be improved by mobile health (mHealth) education. The primary objective of this study will be to analyse the effects of different doses of PBM therapy (7.5 J/cm2 vs 3 J/cm2) plus mHealth education on quality of life (QoL), oral health, salivary secretion and salivary gland ultrasound assessment at postintervention and at the 6-month follow-up in patients with head and neck cancer after radiotherapy compared with those in control group. METHODS AND ANALYSIS: A prospective, three-arm, randomised, placebo-controlled, double-blinded study will be conducted among patients with head and neck cancer suffering from chronic xerostomia. A total of 20 patients per arm will be included and randomly assigned to receive 7.5 J/cm2 of PBM, 3 J/cm2 of PBM or placebo therapy. PBM therapy will be applied during 24 sessions at 22 points extra and intraorally two times per week for 3 months, combined with a mobile application (https://www.laxer.es). The assessments will be recorded at the beginning of the study, at postintervention and at the 6-month follow-up. The primary outcomes will be QoL, oral health, salivary secretion and salivary gland ultrasound. The pain pressure threshold, functional performance, mood and sleep quality will be secondary indicators. ETHICS AND DISSEMINATION: This study received ethics approval from the Andalusian Biomedical Research Ethics Portal (2402-N-21 CEIM/CEI Provincial de Granada) according to the Declaration of Helsinki for Biomedical Research. The results of this study will be presented at national and international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT05106608.

Vacunas frente a la COVID-19: perfil de seguridad tras un año de seguimiento / COVID-19 vaccines: safety profile after one year of follow-up

Introducción: Tras declararse la pandemia mundial por el coronavirus COVID-19, se instauraron medidas para com-batirlo, destacando la existencia de vacunas frente a la COVID-19: dos de ARN mensajero [ARNm] y dos de vector viral no replicante [VVNR]. Nuestro objetivo fue contribuir a la ampliación del perfil de seguridad de dichas vacunas mediante la detección y notificación de reacciones adversas (RAs) en un área sanitaria con 174.398 tarjetas sanitarias durante el año 2021.Método: Estudio observacional descriptivo retrospectivo realizado en un hospital de segundo nivel. Las fuentes de detección de las RAs fueron: Sistema de Codificación del Centro al Alta del Paciente Ingresado [SIAC] y notificación espontánea. Los datos empleados fueron extraídos de la historia clínica electrónica y recogidos en un documento de Microsoft Excell. Resultados: De las 654 RAs detectadas, 36 pertenecieron a vacunas frente a la COVID-19, detectándose el 72 % mediante notificación espontánea y siendo el 91,67 % graves. Se produjeron en 29 pacientes (mediana de edad: 61 años; 51,72 % mujeres), dos de ellos con infección previa por COVID-19. El 50 % de las RAs sucedieron tras la segun-da dosis. Destacaron: trombosis venosa profunda (TVP), tromboembolismo pulmonar (TEP) y miopericarditis con vacunas de ARNm; y vasculitis y miocarditis en VVNR. Conclusiones: Aunque la bibliografía disponible señala que la frecuencia de RAs graves con dichas vacunas suele ser rara, resulta importante su seguimiento. El alto porcentaje de RAs detectadas por notificación espontánea refle-ja la implicación de los profesionales sanitarios en la ampliación del perfil de seguridad. (AU)

Introduction: After declaring the global pandemic due to the coronavirus COVID-19, measures were established to combat it, highlighting the existence of COVID-19 vaccines: two messenger RNA [mRNA] and two non-replicating viral vector [VVNR].Our objective was to contribute to expanding the safety profile of these vaccines through the detection and notifica-tion of adverse reactions (ARs) in a health area with 174,398 health cards during the year 2021.Method: Retrospective descriptive observational study carried out in a second level hospital. The sources of detec-tion of the ADRs were: Coding System of the Center at the Discharge of the Admitted Patient [SIAC] and spontaneous notification. The data used were extracted from the electronic medical record and collected in a Microsoft Excell document.Results: Of the 654 ARs detected, 36 belonged to COVID-19 vaccines, 72 % being detected by spontaneous noti-fication and 91.67 % being serious. They occurred in 29 patients (median age: 61 years; 51.72 % women), two of them with previous COVID-19 infection. 50 % of the ARs occurred after the second dose. They highlighted: deep vein thrombosis (DVT), pulmonary thromboembolism (PTE) and myopericarditis with mRNA vaccines; and vasculitis and myocarditis in VVNR.Conclusions: Although the available bibliography indicates that the frequency of serious ARs with these vaccines is usually rare, their follow-up is important. The high percentage of ADRs detected by spontaneous notification reflects the involvement of healthcare professionals to expanding the safety profile. (AU)

Relationship between mastication and malnutrition in community-dwelling older adults: a meta-analysis

ABSTRACT Purpose To determine the relationship between mastication and malnutrition in community-dwelling older adults. Research strategies To establish the eligibility criteria, the acronym PECOS was used: Population: non-institutionalized older adults; Exposure: older adults with malnutrition; Control: older adults without malnutrition; Outcome: masticatory problems in malnourished older adults; Study types: observational studies. Selection criteria It selected studies assessing malnutrition and mastication difficulties in non-institutionalized adults over 60 years old, of both sexes. Mastication and malnutrition were evaluated with questionnaires on self-reported symptoms and clinical and instrumental assessments. There were no restrictions on language, year of publication, or ethnicity. Data analysis The included studies were evaluated for methodological quality with the Joanna Briggs Institute tool for cross-sectional studies. For the cross-sectional studies included, the odds ratio (OR) was calculated with 95% confidence intervals. Results After searching the databases, 692 references were retrieved, with three studies selected for quantitative and qualitative analysis. The values obtained in the meta-analysis for association show that malnutrition and mastication difficulties were 2.21 times as likely to occur (OR = 2.21; 95%CI = 0.93 - 5.26; I2 = 94%) as individuals without malnutrition (p < 0.001). The assessment of the risk of bias presented a high-risk, a moderate-risk, and a low-risk study. The certainty of evidence was rated very low with the GRADE tool. Conclusion Individuals at risk of malnutrition are 2.21 times as likely to have mastication difficulties.

Encapsulation of Olive Leaf Polyphenol-Rich Extract in Polymeric Micelles to Improve Its Intestinal Permeability.

In the present study, polymeric micelles were developed to improve the intestinal permeability of an extract of Olea europaea L. leaf with a high content of total polyphenols (49% w/w), with 41% w/w corresponding to the oleuropein amount. A pre-formulation study was conducted to obtain a stable formulation with a high loading capacity for extract. The freeze-drying process was considered to improve the stability of the formulation during storage. Micelles were characterized in terms of physical and chemical properties, encapsulation efficiency, stability, and in vitro release. The optimized system consisted of 15 mg/mL of extract, 20 mg/mL of Pluronic L121, 20 mg/mL of Pluronic F68, and 10 mg/mL of D-α-tocopheryl polyethylene glycol succinate (TPGS), with dimensions of 14.21 ± 0.14 nm, a polydisersity index (PdI) of 0.19 ± 0.05 and an encapsulation efficiency of 66.21 ± 1.11%. The influence of the micelles on polyphenol permeability was evaluated using both Parallel Artificial Membrane Permeability Assay (PAMPA) and the Caco-2 cell monolayer. In both assays, the polymeric micelles improved the permeation of polyphenols, as demonstrated by the increase in Pe and Papp values.

Consequences of the COVID-19 pandemic on the mental health of medical students202.

Several studies have shown an increased prevalence of anxiety, depression and suicidal ideation in the general population in relation to the COVID-19 pandemic.

A Rotation Alar Fold Flap for Cosmetic Nasal Plane Reconstruction: Description of the Technique and Outcome in Three Dogs.

Nasal planum reconstruction is a surgical challenge, and several surgical techniques have been described. The objective of this study was to describe the rotation alar fold flap technique and to report clinical outcomes in a short case series. The feasibility of the technique was first assessed in a canine cadaveric model. The rotation alar fold flap was obtained by a single sharp horizontal incision of the dorsolateral nasal cartilage, preserving the caudal mucosal attachment to the ventral nasal concha. The flap was then rotated ventro-medially for the reconstruction of the ventral aspect of the nasal planum unilaterally or bilaterally. The rotation alar fold flap technique was used following a subtotal or partial planectomy for excision of a squamous cell carcinoma or mast cell tumors in three dogs. No intraoperative complications were recorded. Superficial surgical site infection was reported in two cases and minor dehiscence was reported in one case. However, survival of the flap was not affected. The cosmetic and functional outcomes were considered very satisfactory in all cases. The rotation alar fold flap technique offers a safe, valuable, feasible, functional and aesthetically satisfactory alternative surgical option for selected cases of localized tumor involving the central and ventral planum.

Surgical Complications After Lung Transplantation: The Reina Sofía Hospital Experience.

OBJECTIVE: To assess the incidence of surgical complications after lung transplantation and its influence on early mortality and long-term survival. METHODS: Retrospective review of 792 lung transplants (LTs) performed from 1994 to 2022. Among them, 769 with complete data were selected. Patients with and without surgical complications were compared by univariable and multivariable analyses. RESULTS: There were 385 single LTs (50%), 371 double LTs (48%), 8 bilobar LTs (1%), and 5 combined liver LTs (1%). Two hundred forty-nine patients presented surgical complications (32%) as follows: bronchial (n = 61), vascular (n = 55), pneumothorax (n = 33), and phrenic nerve palsy (n = 22). Thirty-day mortality (noncomplicated vs complicated) was 57 (41%) vs 80 (59%), P < .001. Transplants for bronchiectasis (58%), pulmonary hypertension (50%), and re-transplants (78%) presented more surgical complications (P < .001). Double LT (40%), bilobar LT (88%), and combined liver LT (100%) presented more surgical complications (P < .001). Complicated recipients were younger (49 ± 15 vs 45 ± 17 years; P = .001), with longer ischemic times (429 ± 67 vs 450 ± 76 min [2nd graft]; P = .007), and required extracorporeal support (ECLS) more often (43% vs 57%; P < .001). Survival at 1, 5, 10, 15, and 20 years (noncomplicated vs complicated): 78%, 63%, 52%, 41%, 31% vs 52%, 42%, 35%, 26%, 22%; P < .001). Predictors of mortality were the need for ECLS (odds ratio [OR] 4.14; P < .001), postoperative ventilation (hours) (OR 1.01; P < .001), and vascular complications (OR 4.78; P < .001). CONCLUSION: Surgical complications remain an important source of morbidity and mortality after lung transplantation. Complex surgical procedures requiring ECLS develop frequent surgical complications needing long postoperative ventilation that are associated with early mortality and poorer long-term survival.

Case Report of Complex Chest Wall Repair for Sternal Dehiscence After Bilateral Lung Transplantation.

BACKGROUND: We report a case of a complex chest wall reconstruction because of sternal dehiscence, requiring different surgical procedures for its complete resolution. CASE REPORT: A 54-year-old man patient with Langerhans cell histiocytosis and chronic obstructive pulmonary disease underwent bilateral sequential lung transplantation through a clamshell incision, using nitinol thermo-reactive clips for sternal closure. One year later, he consulted because of chest pain, fever, and purulent secretions. Physical examination and chest X-ray revealed a right pulmonary hernia due to post-clamshell wound dehiscence. Chest wall repair was performed, placing an expanded-polytetrafluoroethylene synthetic mesh, and the sternum was realigned and fixated with titanium plates and screws. However, in the immediate postoperative period, there was a large amount of serous drainage through the surgical wound, needing negative pressure therapy. Unfortunately, the wound became necrotic with exposure to the osteosynthesis material. In addition, a chest computed tomography scan showed fluid accumulation in the anterior chest wall. Therefore, two-stage revision surgery was indicated: first, the removal of the previous prosthesis and, the definite one, the use of a pedicled latissimus dorsi myocutaneous flap to provide effective coverage of the wound. CONCLUSION: Sternal dehiscence is not an uncommon complication after clamshell incision in patients undergoing bilateral sequential lung transplantation, and it is associated with significant morbidity. In the presence of chest wall instability, surgical repair is mandatory.

Influence of Donor Type-Donation After Brain Death Versus Donation After Circulatory Death-on Lung Transplant Outcomes.

BACKGROUND: We sought to analyze the influence of lung donor type (brain death [BD] vs controlled donation after cardiac death [DCD]) on lung graft viability and to compare short-term outcomes of lung transplantation using grafts from BD and DCD donors. METHODS: This was a retrospective study of the lung donor population and lung transplants performed at our Institution between January 2020 and December 2022. Demographic characteristics of the donors and donation type (BD vs DCD) were assessed. Lung graft viability rate and post-transplant outcomes were analyzed and compared between donor types. RESULTS: There were 203 donors; among them, 149 (73%) were viable. There were 176 BD donors (87%) and 27 DCD donors (13%), with viability rates of 75% and 59%, respectively, performing 81 single (40%) and 122 double-lung transplants (60%). Recipient PaO2/fraction of inspired oxygen and primary graft dysfunction at 24 and 72 hours did not differ between donor types. Thirty-day mortality did not differ between recipients from BD donors and recipients from DCD donors: n = 28 (21%) vs n = 3 (18%), respectively (P = .81). CONCLUSIONS: Donation after cardiac death donors is a safe source to increase the donor pool for lung transplantation, allowing similar short-term outcomes as lung transplants from BD donors regarding graft function and early survival.

Consecuencias de la pandemia COVID-19 en la salud mental de los estudiantes de medicina / Consequences of the covid-19 pandemic on the mental health of medical students

Introducción. Diversos estudios han demostrado un aumento de la prevalencia de ansiedad, depresión e ideación suicida en la población general en relación con la pandemia COVID-19. Esta prevalencia ha mostrado ser todavía mayor en estudiantes universitarios. El objetivo del presente estudio es analizar la repercusión psicológica sobre los estudiantes de Medicina de la Universidad de Granada y los posibles factores asociados a este impacto. Material y métodos. Se diseñó un cuestionario en formato Google Forms con escalas validadas para ansiedad, depresión e ideación suicida, así como cuestiones sobre otras variables de interés. La recogida de datos se realizó entre marzo y abril 2020. La participación fue voluntaria y anónima. Se realizaron análisis multivariantes de los resultados mediante técnicas de regresión logística para controlar los resultados por múltiples variables de confusión. Resultados. Un total de 297 respuestas fueron recibidas. De los participantes, 215 eran mujeres (72,39%). Se detectó una prevalencia de ansiedad del 51,18%, 70,03% de depresión y 16,84% de ideación suicida. Los principales factores asociados con un mayor grado de morbilidad psíquica fueron, puntuar más alto en la escala de miedo al covid, la presencia comorbida de síntomas de ansiedad y depresión, tener antecedentes previos de ideación suicida o haber consultado con un psiquiatra antes de la pandemia. Conclusión. Los resultados son concordantes con los estudios previos realizados en otras universidades a nivel internacional. Sería recomendable realizar nuevas investigaciones en otras universidades españolas e instaurar programas de prevención y de apoyo psicológico a los estudiantes. (AU)

Introduction. Several studies have shown an increased prevalence of anxiety, depression and suicidal ideation in the general population in relation to the COVID-19 pandemic. This prevalence has been shown to be even higher among university students. The aim of the present study is to analyze the psychological impact on medical students at the University of Granada and the possible factors associated with this impact. Method. A questionnaire was designed in Google Forms with validated scales for anxiety, depression and suicidal ideation, as well as questions about other variables of interest. Data collection took place between March and April 2020. Participation was voluntary and anonymous. Multivariate analysis of the results was performed using logistic regression techniques to control for multiple confounding variables. Results. A total of 297 responses were received. Of the participants, 215 were women (72.39%). A prevalence of anxiety of 51.18%, 70.03% of depression and 16.84% of suicidal ideation was detected. The main factors associated with a higher degree of psychological morbidity were higher scores on the covid fear scale, the comorbid presence of anxiety and depressive symptoms, a previous history of suicidal ideation, or having consulted a psychiatrist before the pandemic. Conclusion: The results are consistent with previous studies carried out in other universities at an international level. It would be advisable to conduct further research in other Spanish universities and to set up prevention and psychological support programs for students. (AU)

Disfunción eréctil y YouTube: calidad de los vídeos en español / Erectile dysfunction and YouTube: Quality of videos in Spanish

Introducción: La disfunción eréctil (DE) es una de las enfermedades urológicas más prevalentes, pero los datos de la calidad de su información en redes sociales son escasos. El objetivo de nuestro estudio fue evaluar la calidad de la información sobre DE contenida en los vídeos de YouTube. Material y métodos: Estudio descriptivo transversal de los 50 primeros vídeos en castellano publicados en YouTube, evaluados por tres urólogos mediante dos cuestionarios validados: Patient Education Materials Assessment Tool (PEMAT) y DISCERN, clasificándolos según puntuación DISCERN en calidad pobre y moderada-buena. Resultados: La mediana de duración fue de 2,42 minutos, y la de visualizaciones, de 94.197 (2.313-3.027.890), con 682,5 (0-54.020) «me gusta» y 39 (0-2.843) «no me gusta». La mediana de PEMAT fue del 29% en inteligibilidad y del 29% en factibilidad. Con DISCERN, 27 vídeos (57,4%) fueron de calidad pobre y 20 (42,6%), de calidad moderada-buena. No observamos diferencias significativas entre ambos grupos en duración, visualizaciones, número de «me gusta» o de «no me gusta». Sí existieron diferencias en PEMAT de inteligibilidad y de factibilidad. El 86,7% de los protagonizados por personal médico fueron de calidad moderada-buena (p=0,001). El 85,7% de los que describían el tratamiento fueron de calidad moderada-buena y el 84% de los vídeos no médicos fueron de calidad pobre (p=0,001). Conclusiones: La mayoría de los vídeos sobre DE en YouTube son de calidad pobre. Los vídeos de mayor calidad son aquellos realizados por profesionales, aunque no son los más vistos. Sería importante el desarrollo de medidas para evitar la difusión de desinformación entre los usuarios de redes sociales. (AU)

Introduction: Erectile dysfunction (ED) is one of the most prevalent urological diseases, but there is limited data about the quality of its information in social networks. The aim of our study was to assess the quality of ED information contained in YouTube videos. Material and methods: Descriptive study of the first 50 Spanish-language videos, published on YouTube, evaluated by three urologists. We used two validated questionnaires: PEMAT (Patient Education Materials Assessment Tool) and DISCERN. Videos were classified according to DISCERN score into poor or moderate-good quality. Results: The median time duration was 2.42minutes (0.15-3.58), 94,197 views (2,313-3,027,890), 682.5 «likes» (0-54,020) and 39 «dislikes» (0-2843). The median of PEMAT score was 29% (9%-95.5%) in understandability and 29% (0-95.5%) in actionability. According to DISCERN score 27 videos (57.4%) had poor quality and 20 (42.6%) moderate-good quality. There were no significant differences between the two groups in time duration, views, «likes» or «dislikes». There were differences in PEMAT score in understandability and actionability. The 86.7% of the moderate-good quality videos were starred by health care provider (P=.001). Also, the 85.7% of videos that describes treatment had moderate-good quality (P=.001). The 84% of the non-medical videos had a poor quality (P=.001). Conclusion: Most ED videos on YouTube have poor quality. The highest quality videos are those made by professionals, although they are not the most viewed. It would be important to develop measures to prevent the spread of misinformation among social network users. (AU)

Influence of De Novo Malignancies on Long-Term Survival after Lung Transplantation.

(1) Background: Malignancies are an important cause of mortality after solid organ transplantation. The purpose of this study was to analyze the incidence of malignancies in patients receiving lung transplants (LT) and their influence on patients' survival. (2) Methods: Review of consecutive LT from 1994 to 2021. Patients with and without malignancies were compared by univariable and multivariable analyses. Survival was compared with Kaplan-Meier and Cox regression analysis. (3) Results: There were 731 LT malignancies developed in 91 patients (12.4%) with related mortality of 47% (n = 43). Native lung cancer, digestive and hematological malignancies were associated with higher lethality. Malignancies were more frequent in males (81%; p = 0.005), transplanted for emphysema (55%; p = 0.003), with cyclosporine-based immunosuppression (58%; p < 0.001), and receiving single LT (65%; p = 0.011). Survival was worse in patients with malignancies (overall) and with native lung cancer. Risk factors for mortality were cyclosporine-based immunosuppression (OR 1.8; 95%CI: 1.3-2.4; p < 0.001) and de novo lung cancer (OR 2.6; 95%CI: 1.5-4.4; p < 0.001). (4) Conclusions: Malignancies are an important source of morbidity and mortality following lung transplantation that should not be neglected. Patients undergoing single LT for emphysema are especially at higher risk of mortality due to lung cancer in the native lung.