Impact of gynecological cancers on health-related quality of life: historical context, measurement instruments, and current knowledge.

Gynecologic cancers, comprising 14.4% of newly diagnosed cancer cases in women globally, are substantial causes of both mortality and morbidity, with a profound impact on the quality of life (QoL) of survivors. Over the past few decades, advancements in interdisciplinary and interprofessional care have contributed to an increase in the average life expectancy of gynecological cancer patients. However, the disease and its treatments have a profound impact on patients, leading to physical changes and psychological consequences, including psychosocial and psychosexual effects, which negatively affect their QoL.The primary objective of management strategies is to minimize harm while improving survival rates and enhancing QoL during the survivorship stage. QoL measures play a crucial role in enhancing our comprehension of how cancer and its treatments affect individuals. Consequently, various measurement instruments, such as the EORTC QLQ 30, PROMIS-29, FACT-G, and QOL-CS, have been developed to assess health-related quality of life (HRQoL). Pre- and post-treatment HRQoL measurements have been shown to be predictive factors for post-operative complications and prognostic factors for overall survival and progression-free survival in gynecological oncology patients. Patient-reported outcomes related to HRQoL are essential tools for measuring patient outcomes and enabling patient-centered clinical decision-making.This article focuses on HRQoL, providing a historical context, summarizing measurement instruments, and discussing the current understanding of the impact of gynecological cancers on HRQoL.

Changes in biomarkers of redox status in serum and saliva of dogs with hypothyroidism.

BACKGROUND: Hypothyroidism is the most common endocrine disorder diagnosed in dogs, leading to deleterious effects on a dog's life quality. This study aims to evaluate changes in the redox status in canine hypothyroidism. For this purpose, a comprehensive panel of antioxidants and oxidants biomarkers were measured in serum and saliva of 23 dogs with hypothyroidism, 21 dogs with non-thyroidal illness, and 16 healthy dogs. Among the antioxidants, cupric reducing antioxidant capacity (CUPRAC), ferric reducing ability of plasma (FRAP), Trolox equivalent antioxidant capacity (TEAC), thiol, paraoxonase type 1 (PON-1) and glutathione peroxidase (GPx) were determined in serum and CUPRAC, ferric reducing ability of saliva (FRAS) and TEAC in saliva. The oxidant biomarkers included were total oxidant status (TOS), peroxide-activity (POX-Act), reactive oxygen-derived compounds (d-ROMs), advanced oxidation protein products (AOPP), and thiobarbituric acid reactive substances (TBARS) in serum and AOPP and TBARS in saliva. RESULTS: Results showed a significantly higher TEAC, PON-1, GPx, TOS, POX-Act, and d-ROMs, and a significantly lower AOPP in serum of dogs with hypothyroidism. Meanwhile, significantly lower FRAS and AOPP were observed in saliva of dogs with hypothyroidism. Once salivary concentrations were corrected based on their total protein concentrations, the only analyte showing significant changes was TBARS which was significantly higher in dogs with hypothyroidism. CONCLUSIONS: Our results show that dogs with hypothyroidism present alterations in the redox status in both serum and saliva. This study should be considered a preliminary study and further research addressing these changes should be made using larger populations.

Security and Privacy Analysis of Youth-Oriented Connected Devices.

Under the Internet of Things paradigm, the emergence and use of a wide variety of connected devices and personalized telematics services have proliferated recently. As a result, along with the penetration of these devices in our daily lives, the users' security and privacy have been compromised due to some weaknesses in connected devices and underlying applications. This article focuses on analyzing the security and privacy of such devices to promote safe Internet use, especially by young people. First, the connected devices most used by the target group are classified, and an exhaustive analysis of the vulnerabilities that concern the user is performed. As a result, a set of differentiated security and privacy issues existing in the devices is identified. The study reveals that many of these vulnerabilities are related to the fact that device manufacturers often prioritize functionalities and services, leaving security aspects in the background. These companies even exploit the data linked to the use of these devices for various purposes, ignoring users' privacy rights. This research aims to raise awareness of severe vulnerabilities in devices and to encourage users to use them correctly. Our results help other researchers address these issues with a more global perspective.

Enfermedad tromboembólica venosa en pacientes con Enfermedades Autoinmunes en el Hospital Reina Sofía de Tudela / Venous thromboembolism in patients with autoimmune disorders a small Hospital

Introducción: Los pacientes con Enfermedades Autoinmunes Sistémicas (EAS) tienen alto riesgo de desarrollar Enfermedad Tromboembólica Venosa (ETV). El comportamiento clínico una vez empiezan con el tratamiento anticoagulante acaba de ser descrito por el grupo RIETE durante este año. Material y métodos: Creamos una base de datos en el Hospital Reina Sofía para comparar las tasas de recurrencias, sangrado mayor y muerte durante el tratamiento anticoagulante de acuerdo a la presencia o ausencia de EAS. Resultados: No se detectan diferencias significativas en las características basales de los pacientes salvo en la presencia de ETV idiopática y de anticuerpos antifosfolípidos. Los enfermos con EAS presentan mayores tasas de recurrencia estando bajo tratamiento anticoagulante y similares tasas de hemorragia y mortalidad. Conclusiones: En un escenario local y más homogéneo de partida que el observado en el RIETE, los enfermos con EAS presentan mayor tendencia a recurrir estando en tratamiento anticoagulante que los enfermos sin esta condición. (AU)

Background: Patients with Autoimmune Disorders (AD) are at increased risk for venous thromboembolism (VTE). The natural history of VTE in these patients has been consistently evaluated by RIETE investigators this year. Methods: We used a newly created database in Reina Sofía´s Hospital to compare the rates of VTE recurrences, major bleeding and death during the course of anticoagulation according to the presence or absence of autoimmune disorders. Results: No significant differences were detected in the baseline characteristics of patients except for the presence of idiopathic VTE and antiphospholipid antibodies. Patients with AD presented higher rates of recurrence while being under anticoagulant treatment and similar rates of bleeding and mortality. Conclusions: In a more local and homogeneous starting scenario than what was observed in the RIETE, patients with AD have a greater tendency to recur while being on anticoagulant treatment than patients without this condition. (AU)

IoT Platform for Energy Sustainability in University Campuses.

University campuses are normally constituted of large buildings responsible for high energy demand, and are also important as demonstration sites for new technologies and systems. This paper presents the results of achieving energy sustainability in a testbed composed of a set of four buildings that constitute the Telecommunications Engineering School of the Universidad Politécnica de Madrid. In the paper, after characterizing the consumption of university buildings for a complete year, different options to achieve more sustainable use of energy are presented, considering the integration of renewable generation sources, namely photovoltaic generation, and monitoring and controlling electricity demand. To ensure the implementation of the desired monitoring and control, an internet of things (IoT) platform based on wireless sensor network (WSN) infrastructure was designed and installed. Such a platform supports a smart system to control the heating, ventilation, and air conditioning (HVAC) and lighting systems in buildings. Furthermore, the paper presents the developed IoT-based platform, as well as the implemented services. As a result, the paper illustrates how providing old existing buildings with the appropriate technology can contribute to the objective of transforming such buildings into nearly zero-energy buildings (nZEB) at a low cost.

The immunogenetic diversity of the HLA system in Mexico correlates with underlying population genetic structure.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) allele groups and alleles by PCR-SSP based typing in a total of 15,318 mixed ancestry Mexicans from all the states of the country divided into 78 sample sets, providing information regarding allelic and haplotypic frequencies and their linkage disequilibrium, as well as admixture estimates and genetic substructure. We identified the presence of 4268 unique HLA extended haplotypes across Mexico and find that the ten most frequent (HF > 1%) HLA haplotypes with significant linkage disequilibrium (Δ'≥0.1) in Mexico (accounting for 20% of the haplotypic diversity of the country) are of primarily Native American ancestry (A*02~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*08~DQB1*04, A*68~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*14~DQB1*03:01, A*24~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*04~DQB1*03:02, A*02~B*40:02~DRB1*04~DQB1*03:02, A*68~B*35~DRB1*04~DQB1*03:02, A*02~B*15:01~DRB1*04~DQB1*03:02). Admixture estimates obtained by a maximum likelihood method using HLA-A/-B/-DRB1 as genetic estimators revealed that the main genetic components in Mexico as a whole are Native American (ranging from 37.8% in the northern part of the country to 81.5% in the southeastern region) and European (ranging from 11.5% in the southeast to 62.6% in northern Mexico). African admixture ranged from 0.0 to 12.7% not following any specific pattern. We were able to detect three major immunogenetic clusters correlating with genetic diversity and differential admixture within Mexico: North, Central and Southeast, which is in accordance with previous reports using genome-wide data. Our findings provide insights into the population immunogenetic substructure of the whole country and add to the knowledge of mixed ancestry Latin American population genetics, important for disease association studies, detection of demographic signatures on population variation and improved allocation of public health resources.

Genetic diversity of HLA system in a population from Guerrero, Mexico.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 144 Mexicans from the state of Guerrero to obtain information regarding allelic and haplotypic frequencies. We find that the ten most frequent haplotypes in the state of Guerrero include eight Native American and two European haplotypes. Admixture estimates revealed that the main genetic components in the state of Guerrero are Native American (61.36 ±â€¯2.69% by ML; 54.17% of Native American haplotypes) and European (35.01 ±â€¯4.59% by ML; 32.29% of European haplotypes), and a relatively low African genetic component (3.63 ±â€¯2.38% by ML; 5.90% of African haplotypes).

Sacubitril-valsartan in heart failure and multimorbidity patients.

AIMS: The poor control of symptoms in patients with advanced heart failure with reduced ejection function (HFrEF) can limit the functionality of patients. Sacubitril-valsartan, compared with enalapril, has been shown to reduce mortality and hospitalization, and nowadays, there is still little evidence about the improvement on functionality. The aim of our study is to analyse the improvement of the functional class and the 6 min walking test (6MWT) in patients with multiple pathologies and advanced heart failure. METHODS AND RESULTS: From September 2016 to March 2018, 65 multimorbidity patients with severe symptomatic HFrEF were initiated to receive sacubitril-valsartan. Mean age was 78.6 ± 7.4 years, and 68% were male. The Charlson co-morbidity index was 8 points. Seventy-four per cent had New York Heart Association (NYHA) Functional Class IV. After the treatment, patients were able to achieve 55.68 m or more on 6MWT, and 91% presented an improvement in the NYHA functional class. CONCLUSIONS: Sacubitril-valsartan relieves symptoms and improves functional class prognostic risk of patients with advanced HFrEF and co-morbidity.

Smart CEI Moncloa: An IoT-based Platform for People Flow and Environmental Monitoring on a Smart University Campus.

Internet of Things platforms for Smart Cities are technologically complex and deploying them at large scale involves high costs and risks. Therefore, pilot schemes that allow validating proof of concepts, experimenting with different technologies and services, and fine-tuning them before migrating them to actual scenarios, are especially important in this context. The IoT platform deployed across the engineering schools of the Universidad Politécnica de Madrid in the Moncloa Campus of International Excellence represents a good example of a test bench for experimentation with Smart City services. This paper presents the main features of this platform, putting special emphasis on the technological challenges faced and on the solutions adopted, as well as on the functionality, services and potential that the platform offers.

Factors associated to institutionalization and mortality over three years, in elderly people with a hip fracture-An observational study.

OBJECTIVE: To identify the factors associated to institutionalization and mortality in elderly patients with hip fractures (HF). DESIGN: Thirty-six months observational study. SETTING: A post-acute rehabilitation ward. PARTICIPANTS: subjects living in the community or in nursing-home, above the age of 65, with HF. MEASUREMENTS: The following were registered: comorbidity, intra-hospital complications, Barthel index, walking ability and Mini Mental State Examination, as well as blood samples upon admission and discharge. Destination upon discharge was recorded as well as mortality during hospital stay and over the three-year follow up. RESULTS: a total of 430 subjects were included in the study. Twenty-three patients (5.3%) died during their stay in hospital and 152 (35.3%) during follow up after discharge. Forty-five patients (10.5%) were institutionalized upon discharge. In adjusted analysis, the factors that predict intra-hospital mortality are higher comorbidity (OR, 1.46; 95%CI, 1.06-2.01), and the number of complications (OR, 1.71; 95%CI, 1.16-2.64). Factors that predict mortality in the long term are age (HR 1.04; 95%CI, 1.01-1.06), comorbidity (HR 1.19, 95% CI, 1.09-1.30), the number of complications (HR 1.17, 95%CI, 1.05-1.31). The factors that predicted new institutionalization were age (OR 1.04, 95%CI, 0.98-1.09), living alone (OR 3.95, 95%CI, 1.38-11.3), and length of hospital stay (OR 1.02 95%CI, 1.00-1.03). CONCLUSIONS: Mortality 3 years after a hip fracture and institutionalization are associated to age, the loss of autonomy in walking, a worse cognitive status and living alone before the fracture. Identification of and, when possible, intervention upon these factors can improve care of elderly people with hip fractures.

Acetato de ulipristal 5 mg en el manejo de los miomas uterinos / No disponible

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A review on architectures and communications technologies for wearable health-monitoring systems.

Nowadays society is demanding more and more smart healthcare services that allow monitoring patient status in a non-invasive way, anywhere and anytime. Thus, healthcare applications are currently facing important challenges guided by the u-health (ubiquitous health) and p-health (pervasive health) paradigms. New emerging technologies can be combined with other widely deployed ones to develop such next-generation healthcare systems. The main objective of this paper is to review and provide more details on the work presented in "LOBIN: E-Textile and Wireless-Sensor-Network-Based Platform for Healthcare Monitoring in Future Hospital Environments", published in the IEEE Transactions on Information Technology in Biomedicine, as well as to extend and update the comparison with other similar systems. As a result, the paper discusses the main advantages and disadvantages of using different architectures and communications technologies to develop wearable systems for pervasive healthcare applications.

Supercritical synthesis of biodiesel.

The synthesis of biodiesel fuel from lipids (vegetable oils and animal fats) has gained in importance as a possible source of renewable non-fossil energy in an attempt to reduce our dependence on petroleum-based fuels. The catalytic processes commonly used for the production of biodiesel fuel present a series of limitations and drawbacks, among them the high energy consumption required for complex purification operations and undesirable side reactions. Supercritical fluid (SCF) technologies offer an interesting alternative to conventional processes for preparing biodiesel. This review highlights the advances, advantages, drawbacks and new tendencies involved in the use of supercritical fluids (SCFs) for biodiesel synthesis.

Rectosigmoid deep infiltrating endometriosis and ureteral involvement with loss of renal function.

UNLABELLED: Endometriosis is a complex disease with unclear pathogenesis, defined as the presence of endometrial tissue (glands and stroma) outside its usual location in the uterine cavity. Ureteral involvement is rare, with an estimated frequency of 10-14% in cases of deep endometriosis with nodules of 3 cm or larger. An important complication of ureteral involvement is asymptomatic loss of renal function. In a patient with asymptomatic renal failure the relevance of extrinsic ureteral involvement by deep endometriosis has been taken to account. CASE REPORT: A 32-year-old nulliparous woman presented with chronic pelvic pain associated with severe dysmenorrhea, dyspareunia and digestive problems including diarrhea, occasional constipation and rectal bleeding. She reported no urological symptoms. Magnetic resonance imaging (MRI) identified a 4 cm nodule in the recto-vaginal septum, compressing and infiltrating the rectal wall, and chronic left hydronephrosis. Isotope renogram revealed 91% function in the right kidney and 9% in the left kidney. A multidisciplinary surgical team including consultants from the departments of digestive surgery and urology assessed the patient. The treatment recommended was a joint approach of laparoscopic surgery to perform adhesiolysis, ureterolysis, freeing of the uterus and appendages, resection of the rectovaginal septum nodule, and left nephrectomy. COMMENT: Diagnosis and treatment of deep endometriosis should be performed in specialized centers and in the context of multidisciplinary collaboration. We must be aware of the potential risk of ureteral involvement and the asymptomatic loss of renal function in any patient with endometriosis nodules of 3 cm or larger.

Control de los factores de riesgo cardiovascular en pacientes con ictus atendidos en Atención Primaria en España. Estudio ICTUSCARE / Control of cardiovascular risk factors in patients with stroke attended in primary care in Spain. ICTUSCARE study

Fundamento: 1) Conocer el grado de control de los factores de riesgo cardiovascular en pacientes con ictus. 2) Analizar el tratamiento farmacológico indicado a los pacientes con ictus.Pacientes y método: Estudio epidemiológico, transversal y multicéntrico. Se incluyeron un total de 975 pacientes con ictus, de los cuales 20 pacientes se excluyeron por incumplir criterios de selección, siendo valorables un total de 955 pacientes. Se evaluaron los factores de riesgo cardiovascular, parámetros relacionados con el grado de control, parámetros analíticos, antropométricos y tratamiento farmacológico indicado.Resultados: Los pacientes incluidos en el estudio habían padecido mayoritariamente un ictus isquémico (61%). El 97,7% de los pacientes presentaron algún factor de riesgo cardiovascular (FRCV) siendo los más frecuentes la hipertensión arterial (84,8%) y dislipemia (61,8%), seguido de obesidad abdominal (42,9%), diabetes mellitus (35,6%) y tabaquismo (25,1%). Sólo el 1,2% de los pacientes presentaban control multifactorial. El 17,6% presentaban control de la presión arterial, el 29,8% del colesterol LDL, el 74,9% no presentaba hábito tabáquico y el 50,2% de los pacientes diabéticos presentaba control de la Hb1Ac. Los tratamientos antihipertensivos más frecuentes fueron los ARA II (57,6%) y los diuréticos tiazídicos (33,4%), de los hipolipemiantes las estatinas (72,8%), de los antidiabéticos la metformina (30,2%), de los antiagregantes el AAS (57,3%) y de los anticoagulantes el acenocumarol (15,0%). El 85,9% de los pacientes estaban antiagregados.Conclusiones: Los pacientes que han sufrido un ictus presentan como FRCV más prevalente la hipertensión arterial. El control de los FRCV en los pacientes que han presentado un ictus es deficiente (AU)

Background: The aim of this cross-sectional, multicenter survey was: 1) To investigate the level of control of cardiovascuar risk factors in patients with a previous stroke. 2) To know the pharmacological therapy used to attain the control. Patients and methods: Data obtained from a total of 955 patients were included in the analysis.. There were evaluated cardiovascular risk factors, parameters related to the degree of control, analytical parameters, antropometric and pharmacological indicated treatment. Results: The majority (61%) had suffered an ischemic stroke and 97.7% presented at least one associated cardiovascular risk factor, being hypertension (84.8%) and dyslipidemia (61.8%) the most frequent. Other factors were abdominal obesity (42.9%), diabetes mellitus (35.6%) and smoking (25.1%). Only 1.2% of the patients presented an adequate control of all cardiovascular risk factors. Only 17.6% had a well controlled blood pressure and in 29.8% LDL-cholesterol was well controlled. In 50.2% of diabetic patients HbA1c was well controlled. Angiotensin receptor blockers were the most widely used antihypertensive drugs (57.6%) while thiazide diuretics were prescribed in 33.4%. Statins were prescribed in 72.8% of patients and metformin, aspirin and acenocumarol in 30.2%, 57.3%, and 15.0% respectively.Conclusions: In conclusion, in patients with a past history of stroke arterial hypertension is the most common cardiovascular risk factor and the control of these factors requires an improvement (AU)

Seroprevalencia de la enfermedad de Lyme en Navarra / No disponble

Fundamento y objetivo: Establecer la seroprevalencia de infección por Borrelia burgdorferi en Navarra (España). Pacientes y método: Se han analizado 1.429 sueros de un listado representativo de la población, aportado por el gobierno de Navarra, estratificado por tres variables: edad, sexo y área de salud, previo consentimiento informado.Resultados: La seroprevalencia global en Navarra de infección por Borrelia burgdorferi es de un 4,4%, habiendo encontrado como factor de riesgo la profesión de ganadero (13,2%) entre las variables analizadas (sexo, edad, contacto con animales, profesión, contacto con medio rural, recuerdo del antecedente de picadura de garrapata o tamaño de la población.) Conclusiones:En Navarra se dan las condiciones adecuadas para el mantenimiento y desarrollo de la enfermedad de Lyme, con una seroprevalencia global del 4,4%. No se han encontrado diferencias entre las diferentes zonas analizadas y sí, como factor de riesgo, la profesión de ganadero (AU)

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[Control of cardiovascular risk factors in patients with stroke attended in primary care in Spain. ICTUSCARE study]. / Control de los factores de riesgo cardiovascular en pacientes con ictus atendidos en Atención Primaria en España. Estudio ICTUSCARE.

BACKGROUND: The aim of this cross-sectional, multicenter survey was: 1) To investigate the level of control of cardiovascuar risk factors in patients with a previous stroke. 2) To know the pharmacological therapy used to attain the control. PATIENTS AND METHODS: Data obtained from a total of 955 patients were included in the analysis.. There were evaluated cardiovascular risk factors, parameters related to the degree of control, analytical parameters, antropometric and pharmacological indicated treatment. RESULTS: The majority (61%) had suffered an ischemic stroke and 97.7% presented at least one associated cardiovascular risk factor, being hypertension (84.8%) and dyslipidemia (61.8%) the most frequent. Other factors were abdominal obesity (42.9%), diabetes mellitus (35.6%) and smoking (25.1%). Only 1.2% of the patients presented an adequate control of all cardiovascular risk factors. Only 17.6% had a well controlled blood pressure and in 29.8% LDL-cholesterol was well controlled. In 50.2% of diabetic patients HbA1c was well controlled. Angiotensin receptor blockers were the most widely used antihypertensive drugs (57.6%) while thiazide diuretics were prescribed in 33.4%. Statins were prescribed in 72.8% of patients and metformin, aspirin and acenocumarol in 30.2%, 57.3%, and 15.0% respectively. CONCLUSIONS: In conclusion, in patients with a past history of stroke arterial hypertension is the most common cardiovascular risk factor and the control of these factors requires an improvement.

[Seroprevalence of Lyme disease in Navarra, Spain]. / Seroprevalencia de la enfermedad de Lyme en Navarra.

BACKGROUND AND OBJECTIVE: To establish the seroprevalence of infection by Borrelia burgdorferi in Navarre (Spain). PATIENTS AND METHOD: Serum samples of 1,429 individuals considered representative of the population of Navarre were analyzed. The individuals were recruited from a list issued by the government of Navarre. The subjects were stratified according to three variables: age, sex and the health zone to which they belonged. In all cases a written informed consent was obtained. RESULTS: The global seroprevalence in Navarre was 4.4%. Being a stockbreeder (13.2%) in contact with cows and sheep was found to be a risk factor after the analysis of different variables such as sex, age, contact with cattle, profession, living in rural areas, a prior history of having been bitten by a tick or the size of the city. CONCLUSIONS: Navarre provides suitable conditions for the prevalence and development of Lyme disease, with a global seroprevalence or 4.4%. No differences were found between the different areas analyzed, while being a stockbreeder represents a risk factor.