Ampliación vesical pediátrica mediante abordaje robótico puro: ¿por qué no? Primer caso en España / Purely robotic ileocystoplasty in children: why not? First case in Spain

Introducción: Presentamos el primer caso de abordaje robóticopediátrico puro en España. Caso clínico. Varón de 12 años con vejiga neurógena de escasacapacidad y altas presiones sin respuesta al tratamiento conservador,abogando por una ileocistoplastia de aumento. Se lleva a cabo un abordaje robótico puro con 4 puertos robóticos y 2 accesorios, de 380 minutosde duración total sin complicaciones intraoperatorias. Es dado de alta alas 2 semanas previo control cistográfico. Tras 32 meses de seguimientocontinúa continente. Comentarios: La mínima invasión, mayor precisión y ergonomíadel abordaje robótico, hacen de este una opción óptima para técnicasquirúrgicas complejas. Dada la difícil disponibilidad del robot y el escasovolumen pediátrico, resulta un reto su normalización en este campo.Nuestra experiencia coincide con la literatura, mostrando resultados quirúrgicos y estéticos prometedores. Esperamos este reporte contribuya a ladifusión e introducción progresiva de la cirugía robótica en nuestra rutina.(AU)

Introduction: We present the first case of pediatric ileocystoplastyusing a purely robotic approach in Spain. Case report: 12-year-old male with neurogenic bladder of low capacity and high pressures. After failure of conservative treatment, bladderaugmentation with ileum patch was decided upon. Surgery was carriedout using a purely robotic approach with 4 robotic and 2 accessoryports. Surgery duration was 380 minutes in total, without intraoperativecomplications. He was discharged 2 weeks after cystographic control.During 32-months follow-up, he has remained continent. Discussion. The minimal invasion, surgical precision and ergonomics made the robotic approach an optimal option for complex surgicaltechniques. Given the little availability of the robot and the low pediatricvolume, its standardization is a challenge. Our accumulated experienceis consistent with the current literature and shows promising surgical andesthetic results. We hope this case report will contribute to the divulga-tion and progressive introduction of robotic surgery in our daily lives.(AU)

Purely robotic ileocystoplasty in children: why not? First case in Spain. / Ampliación vesical pediátrica mediante abordaje robótico puro: ¿por qué no? Primer caso en España.

INTRODUCTION: We present the first case of pediatric ileocystoplasty using a purely robotic approach in Spain. CASE REPORT: 12-year-old male with neurogenic bladder of low capacity and high pressures. After failure of conservative treatment, bladder augmentation with ileum patch was decided upon. Surgery was carried out using a purely robotic approach with 4 robotic and 2 accessory ports. Surgery duration was 380 minutes in total, without intraoperative complications. He was discharged 2 weeks after cystographic control. During 32-months follow-up, he has remained continent. DISCUSSION: The minimal invasion, surgical precision and ergonomics made the robotic approach an optimal option for complex surgical techniques. Given the little availability of the robot and the low pediatric volume, its standardization is a challenge. Our accumulated experience is consistent with the current literature and shows promising surgical and esthetic results. We hope this case report will contribute to the divulgation and progressive introduction of robotic surgery in our daily lives.

INTRODUCCION: Presentamos el primer caso de abordaje robótico pediátrico puro en España. CASO CLINICO: Varón de 12 años con vejiga neurógena de escasa capacidad y altas presiones sin respuesta al tratamiento conservador, abogando por una ileocistoplastia de aumento. Se lleva a cabo un abordaje robótico puro con 4 puertos robóticos y 2 accesorios, de 380 minutos de duración total sin complicaciones intraoperatorias. Es dado de alta a las 2 semanas previo control cistográfico. Tras 32 meses de seguimiento continúa continente. COMENTARIOS: La mínima invasión, mayor precisión y ergonomía del abordaje robótico, hacen de éste una opción óptima para técnicas quirúrgicas complejas. Dada la difícil disponibilidad del robot y el escaso volumen pediátrico, resulta un reto su normalización en este campo. Nuestra experiencia coincide con la literatura, mostrando resultados quirúrgicos y estéticos prometedores. Esperamos este reporte contribuya a la difusión e introducción progresiva de la cirugía robótica en nuestra rutina.

Influence of laparoscopic surgery on the outcomes of radical cystectomy within a multimodal rehabilitation protocol.

INTRODUCTION AND OBJECTIVE: The implementation of Enhanced Recover After Surgery (ERAS) multimodal rehabilitation protocols in radical cystectomy has shown to improve outcomes in hospital stay and complications. The aim of this analysis is to evaluate the impact of laparoscopic surgery on radical cystectomy within a multimodal rehabilitation program. MATERIAL AND METHODS: The study was carried out in a third level center between 2011 and 2020 including patients with bladder cancer submitted to radical cystectomy according to an ERAS (Enhanced Recovery After Surgery) protocol and the Spanish Multimodal Rehabilitation Group (GERM) with 20 items to be fulfilled. RESULTS: A total of 250 radical cystectomies were performed throughout the study period, 42.8% by open surgery (OS) and 57.2% by laparoscopic surgery (LS). The groups are comparable in demographic and clinical variables (p > 0.05). Operative time was longer in the LS group (248.4 ±â€¯55.0 vs. 286.2 ±â€¯51.9 min; p < 0.001). However, bleeding was significantly lower in the LS group (417.5 ±â€¯365.7 vs. 877.9 ±â€¯529.7 cc; p < 0.001), as was the need for blood transfusion (33.6% vs. 58.9%; p < 0.001). Postoperative length of stay (11.5 ±â€¯10.5 vs. 20.1 ±â€¯17.2 days; p < 0.001), total and major complications were also significantly lower in this group (LS). The readmission rate was lower in the LS group but not significantly (36.4% vs. 29.4%; p = 0.237). The difference between 90-day mortality in both groups was not statistically significant (2.8% LS vs. 4.3% OS; p = 0.546). The differences were maintained in the multivariate models. CONCLUSIONS: Laparoscopic surgery within a multimodal rehabilitation program increases operative time but significantly decreases intraoperative bleeding, transfusion requirements, postoperative length of stay, and complications.

Scale of concern about COVID-19 infection in Peruvian Health Care Workers.

INTRODUCTION: The global SARS-CoV-2 pandemic has generated concern about contagion, especially among healthcare workers who are on the front line. OBJECTIVE: To design and analyse the evidence of content validity, internal structure and reliability of a measure of concern about the spread of COVID-19 among Peruvian healthcare workers. MATERIAL AND METHODS: Quantitative study and instrumental design. The scale was administered to 321 health science professionals (78 males and 243 females), whose ages ranged from 22 to 64 years (38.12 ±â€¯9.61). RESULTS: Aiken's V-coefficient values were statistically significant. An exploratory factor analysis was performed which indicated the existence of a single factor, and confirmatory factor analysis (CFA) confirmed a satisfactory six-factor model. The CFA solution obtained adequate fit indices (RMSEA = 0.079; P = .05; TLI = 0.967; IFC = 0.980; GFI = 0.971, and AGFI = 0.931), and showed good internal consistency based on Cronbach's alpha coefficient (α = 0.865; CI 95%, 0.83-0.89). CONCLUSIONS: The scale of concern for COVID-19 infection is a valid and reliable brief measure that can be used for research and professional purposes.

Escala de preocupación por el contagio de la COVID-19 en personal de la salud peruano

Introducción: La pandemia mundial producida por el SARS-CoV-2 ha generado preocupación por el contagio, sobre todo en el personal de salud que está en primera línea. Objetivo: Diseñar y analizar las evidencias de validez de contenido, estructura interna y confiabilidad de una medida de preocupación por el contagio de COVID-19 en personal de salud peruano. Material y métodos: Estudio cuantitativo y diseño instrumental. La escala se aplicó a 321 profesionales de ciencias de la salud (78 varones y 243 mujeres) con edades comprendidas entre los 22 y los 64 (38,12 ± 9,61) an os. Resultados: Los valores del coeficiente V de Aiken fueron estadísticamente significativos. Se realizó un análisis factorial exploratorio, que indicó la existencia de un solo factor. El análisis factorial confirmatorio (AFC) confirmó un modelo satisfactorio de 6 ítems en 1 solo factor. La solución del AFC obtuvo índices de ajuste adecuados (RMSEA = 0,079; p = 0,05; TLI = 0,967; CFI = 0,980; GFI = 0,971 y AGFI = 0,931); además; mostró una buena consistencia interna según el coeficiente alfa de Cronbach (a = 0,865; IC95%, 0,83-0,89). Conclusiones: La escala de preocupación por el contagio de la COVID-19 es una medida breve válida y confiable que se puede utilizar para fines de investigación y función profesional.

A B S T R A C T Introduction: The global SARS-CoV-2 pandemic has generated concern about contagion, especially among healthcare workers who are on the front line. Objective: To design and analyse the evidence of content validity, internal structure and reliability of a measure of concern about the spread of COVID-19 among Peruvian healthcare workers. Material and methods: Quantitative study and instrumental design. The scale was administered to 321 health science professionals (78 males and 243 females), whose ages ranged from 22 to 64 years (38.12±9.61). Results: Aiken's V-coefficient values were statistically significant. An exploratory factor analysis was performed which indicated the existence of a single factor, and confirmatory factor analysis (CFA) confirmed a satisfactory six-factor model. The CFA solution obtained adequate fit indices (RMSEA = 0.079; p = 0.05; TLI = 0.967; IFC = 0.980; GFI = 0.971, and AGFI = 0.931), and showed good internal consistency based on Cronbach's alpha coefficient (a = 0.865; CI 95%, 0.83-0.89). Conclusions: The scale of concern for COVID-19 infection is a valid and reliable brief measure that can be used for research and professional purposes.

Integrated full-scale solar CPC/UV-LED-filtration system as a tertiary treatment in a conventional WWTP for agricultural reuse purposes.

Today, the emergence of increasingly restrictive treatment and reuse policies make the implementation of full-scale tertiary treatment, capable of improving the quality of water, a priority. Full-scale TiO2 photocatalysis systems are resulting in a promising option, since TiO2 is commercially available. However, questions such as how to work continuously during day/night irradiation cycle, or the removing of TiO2 in outlet flow are still unresolved. In this work, a full-scale system integrating a solar CPC/UV-LED step combined with commercial microfiltration membranes was installed in a conventional WWTP for agricultural reuse purposes. After optimization, 0.5 g/L of catalyst and combined SOLAR + UV-LED showing the highest pharmaceutical removal percentages, while a self-designed UV-LED included in the own reaction tank resulting in higher efficiencies compared with commercial lamps. Longer membrane surface area decreased fouling problems in the system. However, 60 min of irradiation time was necessary to reach the most restrictive water quality values according with (EU 2020/741). After optimization step, total costs were reduced by 45%. However, it was shown that a reduction in operating and maintenance costs, along with the development of more effective and economical commercial filtration membranes is a key factor; therefore, working on these aspects is essential in the treated water cost reduction.

[Scale of Concern about COVID-19 Infection in Peruvian Health Care Workers]. / Escala de preocupación por el contagio de la COVID-19 en personal de la salud peruano.

Introduction: The global SARS-CoV-2 pandemic has generated concern about contagion, especially among healthcare workers who are on the front line. Objective: To design and analyse the evidence of content validity, internal structure and reliability of a measure of concern about the spread of COVID-19 among Peruvian healthcare workers. Material and methods: Quantitative study and instrumental design. The scale was administered to 321 health science professionals (78 males and 243 females), whose ages ranged from 22 to 64 years (38.12 ± 9.61). Results: Aiken's V-coefficient values were statistically significant. An exploratory factor analysis was performed which indicated the existence of a single factor, and confirmatory factor analysis (CFA) confirmed a satisfactory six-factor model. The CFA solution obtained adequate fit indices (RMSEA = 0.079; p = 0.05; TLI = 0.967; IFC = 0.980; GFI = 0.971, and AGFI = 0.931), and showed good internal consistency based on Cronbach's alpha coefficient (α = 0.865; CI 95%, 0.83-0.89). Conclusions: The scale of concern for COVID-19 infection is a valid and reliable brief measure that can be used for research and professional purposes.

Risk assessment for uptake and accumulation of pharmaceuticals by baby leaf lettuce irrigated with reclaimed water under commercial agricultural activities.

The use of reclaimed water to irrigate agricultural crops has increased in recent years as a consequence of water shortage constituting a potential risk for human health. The main objective of this study was to evaluate the impact on the soil-plant system and determining the accumulation of carbamazepine (CBZ), diclofenac (DCF), ketoprofen (KTP) and naproxen (NPX) in the edible part of lettuce under commonly used agricultural practices in commercial production. For this purpose, red oak baby lettuce (Lactuca sativa L.) was irrigated with reclaimed water fortified with different concentrations of pharmaceuticals. The study was carried out in two different scenarios: soil and tray. The tray experiments were conducted with substrate and took place at three different seasons of the year. Lettuce tissue sampled from these experiments were analysed 3 times during the lettuce growing cycle (first, second and third harvest). The practices of first harvest regrowth were also evaluated. For all experiments, CBZ showed the highest accumulation in lettuce leaves of the pharmaceuticals tested, showing a correlation between irrigation exposure time and pharmaceutical uptake. Unexpectedly, DCF was the compound with the highest uptake levels after regrowth practices. Results suggested that pharmaceuticals uptake could be directly associated with the irrigation method and possible accumulation in soil and substrates, while concentration of pharmaceuticals in substrates were 10 times higher. Based on the concentration values detected in lettuce leaves, the risk assessment suggests that no compounds imply any risk to human health, except CBZ for those on vegetarian diets in the tray scenario. Although commercial agricultural practices are usually not considered with regards to risk reduction, in this experiment we demonstrated that climatic conditions are a key factor in pharmaceuticals uptake and different agricultural practices (soil cropping and drip irrigation) can limit the presence of pharmaceutical compounds in crops.

Validity of a scale of Latin American perception of fear and concern transmitted by the media during the pandemic (MED-LAT-COVID-19).

Introduction: The pandemic has caused fear, especially due to the daily disseminated news; however, there is not an instrument to measure this fear in multiple realities. Objective: To validate a scale for Latin American perception of fear and concern transmitted by the media during the pandemic. Methodology: This is an instrumental study. The survey was based on an instrument which was pre-validated in Peru and submitted to 15 experts in almost 10 countries. Subsequently, thousands of people were surveyed in 13 Latin American countries, whose answers were used for descriptive statistics for validation. Results: Confirmatory Factor Analysis (CFA) generated two re-specifications, where four items were eliminated from the original scale. With these changes, the global goodness of fit (absolute and incremental) were satisfactory (CFI = 0.978; TLI = 0.964; GFI = 0.976; AGFI = 0.949; RMSEA = 0.075 and RMR = 0.029). The first factor measures the media exaggeration (three questions); the second, the fear transmitted by the media (three questions); and the third, the fear transmitted by others different from the media (two questions). The Cronbach's alpha coefficient was higher than 0.70 for the scale and its factors. Conclusion: The MED-LAT-COVID-19 scale reported a good adjustment. It has eight items in three factors, which could be measured in an isolated way, or along with other tests that assess mental health in the current pandemic context.

Randomized phase II study of fulvestrant plus palbociclib or placebo in endocrine-sensitive, hormone receptor-positive/HER2-advanced breast cancer: GEICAM/2014-12 (FLIPPER).

BACKGROUND: The potential benefit of adding palbociclib to fulvestrant as first-line treatment in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative endocrine-sensitive advanced breast cancer (ABC) patients remains uncharacterized. PATIENTS AND METHODS: In this randomized (1:1), double-blind, phase II study, postmenopausal women with HR-positive, HER2-negative ABC with de novo metastatic disease or those who relapsed after >12 months of adjuvant endocrine therapy received palbociclib/fulvestrant or placebo/fulvestrant. Stratification was based on recurrent versus de novo metastatic disease and visceral involvement. The primary objective was one-year progression-free survival (PFS-1y) rate. The sample size was 190 patients. The two-sided alpha of 0.2, 80% of power to detect a difference between the arms, assuming PFS rates of 0.695 and 0.545 for palbociclib/fulvestrant and placebo/fulvestrant, respectively. RESULTS: In total, 189 patients were randomized to palbociclib/fulvestrant ([n = 94] or placebo/fulvestrant [n = 95]). 45.5% and 60.3% of patients had de novo metastatic disease and visceral involvement, respectively. PFS-1y rates were 83.5% and 71.9% in the palbociclib/fulvestrant and placebo/fulvestrant arms, (HR 0.55, 80% CI 0.36-0.83, P = 0.064). The median PFS were 31.8 and 22.0 months for the palbociclib/fulvestrant and placebo/fulvestrant arms (aHR 0.48, 80% CI 0.37-0.64, P = 0.001). The most frequent grade 3-4 adverse events were neutropenia (68.1% vs. 0%), leucopenia (26.6% vs. 0%), anemia (3.2% vs. 0%), and lymphopenia (14.9% vs. 2.1%) for the palbociclib/fulvestrant and placebo/fulvestrant, respectively. The most frequent non-hematologic grade 3-4 adverse event was fatigue (4.3% vs. 0%). CONCLUSIONS: Palbociclib/fulvestrant demonstrated better PFS-1y rates and median PFS than placebo/fulvestrant in HR-positive/HER2-negative endocrine-sensitive ABC patients.

Scale of Concern about COVID-19 Infection in Peruvian Health Care Workers. / Escala de preocupación por el contagio de la COVID-19 en personal de la salud peruano.

INTRODUCTION: The global SARS-CoV-2 pandemic has generated concern about contagion, especially among healthcare workers who are on the front line. OBJECTIVE: To design and analyse the evidence of content validity, internal structure and reliability of a measure of concern about the spread of COVID-19 among Peruvian healthcare workers. MATERIAL AND METHODS: Quantitative study and instrumental design. The scale was administered to 321 health science professionals (78 males and 243 females), whose ages ranged from 22 to 64 years (38.12±9.61). RESULTS: Aiken's V-coefficient values were statistically significant. An exploratory factor analysis was performed which indicated the existence of a single factor, and confirmatory factor analysis (CFA) confirmed a satisfactory six-factor model. The CFA solution obtained adequate fit indices (RMSEA=0.079; p=0.05; TLI=0.967; IFC=0.980; GFI=0.971, and AGFI=0.931), and showed good internal consistency based on Cronbach's alpha coefficient (α=0.865; CI 95%, 0.83-0.89). CONCLUSIONS: The scale of concern for COVID-19 infection is a valid and reliable brief measure that can be used for research and professional purposes.

Immune microenvironment characterisation and dynamics during anti-HER2-based neoadjuvant treatment in HER2-positive breast cancer.

Despite their recognised role in HER2-positive (HER2+) breast cancer (BC), the composition, localisation and functional orientation of immune cells within tumour microenvironment, as well as its dynamics during anti-HER2 treatment, is largely unknown. We here investigate changes in tumour-immune contexture, as assessed by stromal tumour-infiltrating lymphocytes (sTILs) and by multiplexed spatial cellular phenotyping, during treatment with lapatinib-trastuzumab in HER2+ BC patients (PAMELA trial). Moreover, we evaluate the relationship of tumour-immune contexture with hormone receptor status, intrinsic subtype and immune-related gene expression. sTIL levels increase after 2 weeks of HER2 blockade in HR-negative disease and HER2-enriched subtype. This is linked to a concomitant increase in cell density of all four immune subpopulations (CD3+, CD4+, CD8+, Foxp3+). Moreover, immune contexture analysis showed that immune cells spatially interacting with tumour cells have the strongest association with response to anti-HER2 treatment. Subsequently, sTILs consistently decrease at the surgery in patients achieving pathologic complete response, whereas most residual tumours at surgery remain inflamed, possibly reflecting a progressive loss of function of T cells. Understanding the features of the resulting tumour immunosuppressive microenvironment has crucial implications for the design of new strategies to de-escalate or escalate systemic therapy in early-stage HER2+ BC.

Repercusión académica de la COVID-19 en universitarios peruanos / Academic impact of COVID-19 on Peruvian university students

Introducción: La pandemia del coronavirus ha generado que muchos estudiantes teman perder el ciclo. Objetivo: Validar una escala que mida la percepción de posibles repercusiones académicas en estudiantes universitarios en el Perú. Metodología: Se realizó un proceso de validación de un test que mide la percepción acerca de las posibles repercusiones académicas en estudiantes universitarios. La validación se realizó mediante búsqueda de literatura científica, construcción del primer bosquejo, validación del test por expertos (59 expertos: epidemiólogos, investigadores, médicos), análisis factorial exploratorio y estadístico. Resultados: Respecto a la relevancia se observa que el ítem 7 es más esencial o importante que los demás (V = 1,00; IC 95 por ciento: 0,73-0,96). El ítem 8 (M = 3,80; /= 1,152) presenta la mayor media y, la más baja, el ítem 6 (M = 3,03; DE = 1,342). La pertinencia del AFE se justifica con el índice KMO (0,85) y la prueba de Bartlett (12577,0; gl = 28; p = / 0,001) siendo aceptables y significativos. Se obtuvo un coeficiente α de Cronbach de 0,899 con un intervalo de confianza del 95 por ciento de 0,882-0,898; indicando que la consistencia del instrumento es buena. Conclusiones: Se validó una escala de factor único que mide la percepción que tienen los estudiantes universitarios acerca de las posibles repercusiones de la pandemia del coronavirus en sus estudios. Es necesario evaluar cada realidad y el instrumento puede servir como una escala base para ello(AU)

Introduction: As a result of the coronavirus pandemic, many students are worried that they may lose their academic term. Objective: Validate a scale to measure the perception of possible academic impacts among Peruvian university students. Method: A validation process was conducted of a test measuring the perception of university students about possible academic impacts. The validation was based on a scientific bibliography search, development of a preliminary overview, validation of the test by 59 experts: epidemiologists, researchers and physicians, exploratory factor analysis, and statistical analysis. Results: In terms of relevance, item 7 was found to be more essential or important than the others (V = 1.00; CI 95 percent: 0.73-0.96). Item 8 (M = 3.80; /= 1.152) exhibits the highest mean, and item 6 the lowest (M = 3.03; SD = 1.342). AFE relevance is justified by the KMO index (0.85) and Bartlett's test (12577.0; gl = 28; p = / 0.001), both of which were found to be acceptable and significant. A Cronbach's α coefficient of 0.899 was obtained, with a confidence interval of 95 percent, SD 0.882-0.898, indicating a good consistency level. Conclusions: A single factor scale was validated which measures the perception of university students about the possible impacts of the coronavirus pandemic on their studies. It is necessary to evaluate each reality, and the tool may serve as a base scale for that purpose(AU)

Percepción de las medidas de salud pública en Perú para frenar el avance de la COVID-19 / Perception of the public health measures implemented in Peru to stop the spread of COVID-19

Introducción: Es importante medir en la población la percepción del impacto que han tenido las medidas adoptadas por los gobiernos ante la rápida expansión del coronavirus. Objetivo: Determinar la percepción de las medidas implementadas por el gobierno de Perú en materia de salud pública para frenar el avance de la COVID-19. Métodos: Estudio transversal, analítico y multicéntrico, para el cual se hizo una encuesta virtual en la que participaron más de 4000 personas de todo el país. Resultados: La gran mayoría estaban a favor que esta es una epidemia/pandemia grave (47 por ciento de acuerdo y 42 por ciento muy de acuerdo), sin embargo, solo el 22 por ciento, 21 por ciento, 17 por ciento y 46 por ciento que el país, el sector salud, los hospitales y los médicos, respectivamente, están preparados para enfrentarla. Las medidas más apoyadas en cuanto a migración fueron la aprobación del cierre de fronteras (68 por ciento muy de acuerdo) y no dejar entrar a quienes estuvieron en China u otros países con elevadas cifras de casos de coronavirus (60 por ciento muy de acuerdo). Asimismo, estuvieron de acuerdo que no deben celebrarse eventos masivos por un tiempo (69 por ciento muy de acuerdo), seguidos por quienes proponían declarar la salud pública en emergencia (61 por ciento muy de acuerdo) y el cierren de colegios y universidades por un tiempo (50 por ciento muy de acuerdo). Se encontraron muchas asociaciones estadísticas de estas percepciones, según sexo, edad o grado académico (p < 0,05). Conclusiones: La población estuvo de acuerdo con la mayoría de las medidas, algunas fueron más apoyadas y estuvieron asociadas a las características socioeducativas(AU)

ABSTRACT measures taken by governments in response to the fast spread of the coronavirus. Objective: Determine the perception of the public health measures implemented by the Peruvian government to stop the spread of COVID-19. Methods: A multicenter cross-sectional analytical study was conducted based on a virtual survey applied to more than 4 000 people across the country. Results: The vast majority of respondents agreed that COVID-19 is a serious epidemic / pandemic (47% in agreement and 42% very much in agreement). However, only 22%, 21%, 17% and 46% thought that the country, the health sector, the hospitals and the doctors, respectively, were prepared to face it. The most widely supported migration measures were border closure (68% very much in agreement) and denying entrance to travelers returning from China or other countries with high rates of coronavirus infection (60% very much in agreement). Respondents agreed that mass gatherings should not be held for a while (69% very much in agreement), a figure followed by those proposing to declare a public health emergency (61% very much in agreement) and the closure of colleges and universities for some time (50% very much in agreement). Many statistical associations of these perceptions were found, according to sex, age or educational level (p < 0.05). Conclusions: The population supports most of the measures, those related to socioeducational characteristics receiving greater support(AU)

[Current status of epilepsy surgery in Spain. Compendium and awareness]. / Estado actual de la cirugía de la epilepsia en España. Compendio y conciencia.

INTRODUCTION: Drug-resistant epilepsy affects between a third and a quarter of patients with epilepsy. Within this group, with a poorer quality of life and high healthcare costs, there is a considerable proportion of patients with potentially surgical causes of epilepsy, and epilepsy surgery is a proven therapeutic option. In Spain, we do not know the actual number of patients who are treated in relation to the total number of cases of refractory epilepsy that could benefit from surgical treatment. AIM: To analyse the number of epilepsy surgical interventions performed and published in relation to the potential cases of refractory epilepsy who are candidates for surgery in our country. METHOD: A review was carried out through a literature search in PubMed and Cochrane of articles published between 1990 and 2020, combining the following words and Boolean operators: 'epilepsy surgery IN Spain'. The evidence and recommendations were classified according to the prognostic criteria of the Oxford Centre for Evidence Based Medicine (2001) and of Neurological Societies (2004) for therapeutic actions. RESULTS: The majority (75.6%) of the publications came from the autonomous communities of Madrid and Catalonia and 46.4% of the articles published were short series. We counted 2,113 surgical interventions (resections, palliative interventions, implantation of deep electrodes and implantation of neurostimulators), which represents 8.7% of the estimated population with refractory epilepsy. CONCLUSION: Epilepsy surgery in our country is an underused therapeutic indication that is not offered or administered to the majority of potential beneficiaries.

TITLE: Estado actual de la cirugía de la epilepsia en España. Compendio y conciencia.Introducción. La epilepsia refractaria al tratamiento médico afecta a entre un tercio y una cuarta parte de los pacientes con epilepsia. Dentro de este grupo, con peor calidad de vida y altos costes sanitarios, existe una considerable proporción de pacientes con causas de epilepsia potencialmente quirúrgicas, y la cirugía de la epilepsia es una opción terapéutica comprobada. En España no sabemos el número real de pacientes que llegan a tratarse en relación con el total de los casos con epilepsia refractaria que podrían beneficiarse del tratamiento quirúrgico. Objetivo. Analizar el número de cirugías de epilepsia realizadas y publicadas en relación con los potenciales casos de epilepsia refractaria candidatos a cirugía en nuestro país. Método. Se realizó una revisión mediante la búsqueda bibliográfica en PubMed y Cochrane de artículos publicados entre 1990 y 2020, combinando las siguientes palabras y operadores booleanos: 'epilepsy surgery IN Spain'. Se clasificaron las evidencias y recomendaciones según los criterios pronósticos del Oxford Center for Evidence Based Medicine (2001) y de la European Federation of Neurological Societies (2004) para actuaciones terapéuticas. Resultados. El 75,6% de las publicaciones se originó en las comunidades autónomas de Madrid y Cataluña. El 46,4% de los artículos publicados son de series cortas. Contabilizamos 2.113 intervenciones quirúrgicas (resecciones, cirugías paliativas, implantación de electrodos profundos e implantación de neuroestimuladores), lo que representa el 8,7% de la población estimada con epilepsia refractaria. Conclusión. La cirugía de la epilepsia en nuestro medio es una indicación terapéutica infrautilizada y que no se ofrece o no se administra a la mayoría de los potenciales beneficiarios.

Percepción de los efectos COVID-19 en la educación presencial y a distancia en estudiantes universitarios del Perú / Perception of the COVID-19 effects in face-to-face and distance education in peruvian university students

La pandemia originó muchos cambios debido al distanciamiento social, uno de ellos es en cuanto a las clases virtuales universitarias. Por esto, el objetivo fue validar un instrumento que mida la percepción de los efectos del COVID-19 sobre la educación a distancia en estudiantes universitarios de las ciencias de la salud y otras carreras en el Perú. Se realizó un estudio instrumental y transversal. Participaron miles de estudiantes de ciencias de la salud y de otras carreras que estudiaban a distancia durante la primera ola del Coronavirus. Se diseñó y validó la encuesta sobre la percepción de que tiene de las repercusiones que causó la emergencia sanitaria sobre en la educación presencial y a distancia; además, se validó de forma exploratoria otra escala para medir la percepción de la propagación del coronavirus. El análisis arrojó alta confiabilidad y buena consistencia interna, con adecuados valores del alfa de Cronbach, para el Análisis Factorial Exploratorio (AFE) se empleó la prueba de Bartlett y el coeficiente Kaiser-Meyer-Olkin. Todos los ítems recibieron una evaluación favorable por parte de los expertos (V de Aiken > 0,70); esto con respecto de la relevancia, representatividad y claridad. Se identificó tres factores medios virtuales, su uso y la presencialidad, todos índices de saturación fueron superiores a 0,50. La encuesta demostró ser confiable y representativa, esto sobre todo por haber sido evaluada en estudiantes de los distintos departamentos peruanos; la cual puede servir para evaluar esto en diversas poblaciones semejantes(AU)

The pandemic caused many changes due to social distancing, one of them is in terms of virtual university classes. Therefore, the objective was to validate an instrument that measures the perception of the effects of COVID-19 on distance education in university students of health sciences and other careers in Peru. An instrumental and cross-sectional study was carried out. Thousands of distance learning students from health sciences and other careers participated during the first wave of the Coronavirus. The survey on the perception that it has of the repercussions caused by the health emergency on face-to-face and distance education was designed and validated; in addition, another scale was exploratory to measure the perception of the spread of the coronavirus. The analysis showed high reliability and good internal consistency, with adequate Cronbach's alpha values. For the Exploratory Factor Analysis (EFA), the Bartlett test and the Kaiser-Meyer-Olkin coefficient were used. All the items received a favorable evaluation by the experts (Aiken's V> 0.70); this with respect to relevance, representativeness and clarity. Three virtual average factors were identified, their use and presence, all saturation indices were greater than 0.50. The survey proved to be reliable and representative, this above all because it was evaluated in students from the different Peruvian departments; which can be used to evaluate this in diverse similar populations(AU)