Partial-accelerated irradiation with stereotactic radiotherapy at a dose of 30 Gy in 5 fractions in early breast cancer.

PURPOSE: To evaluate feasibility of accelerated partial breast irradiation (APBI) using stereotactic radiotherapy (SBRT) Thirty Gy delivered in 5 fractions for patients with early breast cancer. METHODS: Between January 1st, 2018, and December 31s, 2022, we conducted 117 treatments for patients with early-stage breast cancer. All patients underwent conservative surgery followed by APBI using stereotactic external beam radiotherapy. We analyzed local, regional, distant control, overall survival, toxicity, and cosmetic outcomes. RESULTS: The average age was 62 years. 21.3% ductal and 78.7% invasive carcinomas. Regarding the PTV volume, the median was 198.8 cc (38-794 cc). Treatments were completed in all cases. The median follow-up period was of 21 months (1-62 months). Regarding acute toxicity, no Grade 3-4 toxicities were recorded. One patient experienced Grade 2 neuropathic pain. One patient developed subacute fibrosis and two patients developed telangiectasia as subacute and chronic toxicity. Cosmetic results were "good" or "very good" in 96.3% of cases. None of the patients relapsed at any level (local, regional, or distant) and overall survival during follow.up was 100%. CONCLUSION: APBI with SBRT 30 Gy in 5 fractions in early-stage breast cancer is a feasible technique, very-well tolerated and has excellent oncologic and cosmetic outcome during our follow-up period.

Involvement of Personality and Health Status in the Psychological Wellbeing of Subjects with Chronic Disease.

(1) Background: Psychological wellbeing correlates with improved physical and psychological health, as this construct plays a fundamental role in disease recovery and health maintenance. Hence, for healthcare professionals, understanding the factors that predict psychological wellbeing is of great interest. Thus, the objective of this study was to determine whether health status and personality traits influence psychological wellbeing. (2) Methods: The total sample (N = 600) consisted of HIV patients, individuals with diabetes, and healthy subjects from the Salamanca Clinical Hospital. The instruments used for data collection included a sociodemographic questionnaire, Ryff's Psychological Wellbeing Scale, and the Spanish version of the Big Five Taxonomy to measure personality. (3) Results: Specific personality traits, such as Emotional Stability, Extraversion, Responsibility, and Integrity were significant predictors of different dimensions of psychological wellbeing. Regarding health status, individuals with diabetes and healthy subjects, compared to HIV+ subjects, were associated with higher levels of psychological wellbeing dimensions. (4) Conclusions: Individual differences in personality traits and the diagnosis of a chronic condition may play a fundamental role in psychological wellbeing. These conclusions are of great interest for developing strategies aimed at individuals with chronic illnesses and specific personality traits associated with poorer psychological wellbeing.

Materials Science Toolkit for Carbon Footprint Assessment: A Case Study for Endoscopic Accessories of Common Use.

Ironically, healthcare systems are key agents in respiratory-related diseases and estimated deaths because of the high impact of their greenhouse gas emissions, along with industry, transportation, and housing. Based on safety requirements, hospitals and related services use an extensive number of consumables, most of which end up incinerated at the end of their life cycle. A thorough assessment of the carbon footprint of such devices typically requires knowing precise information about the manufacturing process, which is rarely available in detail because of the many materials, pieces, and steps involved during the fabrication. Yet, the tools most often used for determining the environmental impact of consumer goods require a bunch of parameters, mainly based on the material composition of the device. Here, we report a basic set of analytical methods that provide the information required by the software OpenLCA to calculate the main outcome related to environmental impact, greenhouse gas emissions. Through thermogravimetry, calorimetry, infrared spectroscopy, and elemental analysis, we proved that obtaining relevant data for the calculator in the exemplifying case of endoscopy tooling or accessories is possible. This routine procedure opens the door to a broader, more accurate analysis of the environmental impact of everyday work at hospital services, offering potential alternatives to minimize it.

High depressive symptomatology reduces emotional reactions to pictures of social interaction.

Individuals with severe depressive symptoms present diminished facial expressions compared to healthy individuals. This reduced facial expression, which occurs in most depressive patients could impair social relationships. The current study sought to investigate whether pictures with social interaction cues could elicit different modulations of facial expressions and mood states in individuals with depressive symptoms compared to healthy individuals. A total of 85 individuals were divided into depressive and non-depressive groups based on their beck depression inventory scores. Participants viewed pictures containing neutral (objects), affiliative (people interacting socially), and control (people not interacting) scenes. Electromyographic signals were collected during the entire period of visualization of the blocks, and emotional questionnaires were evaluated after each block to assess sociability and altruism (prosocial states). In non-depressed individuals, affiliative pictures increased the activity of the zygomatic muscle compared to both neutral and control pictures and reduced fear of rejection compared to neutral pictures. During the visualization of the affiliative block, zygomatic major muscle activation was higher and fear of rejection was lower in the non-depressive individuals than in the depressive. These effects reflected the low expressions of smiling and sociability to affiliative pictures in depressive individuals. These findings highlight the importance of smiling and prosocial states in social interactions, especially in these individuals.

Application of Biostimulant in Seeds and Soil on Three Chickpea Varieties: Impacts on Germination, Vegetative Development, and Bacterial Facilitation of Nitrogen and Phosphorus.

Chickpeas (Cicer arietinum L.) are a valuable legume crop due to their nutritional value. To maintain chickpea productivity and avoid the adverse effects of climate change on soil and plant processes, it is crucial to address demand. Achieving this necessitates implementing sustainable agricultural practices incorporating the use of biostimulants, adaptable crops for arid conditions, as well as pest and disease-resistant crops that are sustainable over time. Three varieties of chickpeas were analysed to determine the effect of two different biostimulant application methods on both germination and vegetative growth. Possible effects due to location were also examined by conducting tests at two different sites. Significant variations in biostimulant response were evident only during the germination period, but not during the vegetative development stage, where the observed statistical differences were influenced more by the location or variety of chickpeas employed. Furthermore, this study examined the effect of biostimulants on nutrient cycling within the soil-plant microbiota system. Nitrogen-fixing bacteria (NFB) are present in the soil of chickpea crops at an order of magnitude of 107 CFU/g DS. Additionally, an average concentration of 106 CFU/g DS of phosphorus-mobilising bacteria was observed. Applying biostimulants (BioE) to seeds resulted in a successful germination percentage (GP) for both Amelia (AM) and IMIDRA 10 (IM) varieties.

Alterations in circulating mitochondrial signals at hospital admission for COPD exacerbation.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) exacerbation (ECOPD) alters the natural course of the disease. To date, only C-reactive protein has been used as a biomarker in ECOPD, but it has important limitations. The mitochondria release peptides (Humanin (HN), FGF-21, GDF-15, MOTS-c and Romo1) under certain metabolic conditions. Here, we aimed to evaluate the pathophysiologic, diagnostic and prognostic value of measuring serum mitochondrial peptides at hospital admission in patients with ECOPD. METHODS: A total of 51 consecutive patients admitted to our hospital for ECOPD were included and followed for 1 year; in addition, 160 participants with stable COPD from our out-patient clinic were recruited as controls. RESULTS: Serum FGF-21 (p < .001), MOTS-c (p < .001) and Romo1 (p = .002) levels were lower, and GDF-15 (p < .001) levels were higher, in patients with ECOPD than stable COPD, but no differences were found in HN. In receiver operating characteristic analysis, MOTS-c (AUC 0.744, 95% CI 0.679-0.802, p < .001) and GDF-15 (AUC 0.735, 95% CI 0.670-0.793, p < .001) had the best diagnostic power for ECOPD, with a diagnostic accuracy similar to that of C-RP (AUC 0.796 95% IC 0.735-0.848, p < .001). FGF-21 (AUC 0.700, 95% CI 0.633-0.761, p < .001) and Romo1 (AUC 0.645 95% CI 0.573-0.712, p = .001) had lower diagnostic accuracy. HN levels did not differentiate patients with ECOPD versus stable COPD (p = .557). In Cox regression analysis, HN (HR 2.661, CI95% 1.009-7.016, p = .048) and MOTS-c (HR 3.441, CI95% 1.252-9.297, p = .016) levels exceeding mean levels were independent risk factors for re-admission. CONCLUSIONS: Most mitochondrial peptides are altered in ECOPD, as compared with stable COPD. MOTS-c and GDF15 levels have a diagnostic accuracy similar to C-RP for ECOPD. HN and MOTS-c independently predict future re-hospitalization.

Correction: Rivera-Picón et al. Factors Associated with Adherence to Treatment in Patients with HIV and Diabetes Mellitus. J. Pers. Med. 2023, 13, 269.

There was an error in the original publication [...].

Mediterranean Diet for Primary and Secondary Prevention of Cardiovascular Disease and Mortality: An Updated Systematic Review.

Cardiovascular diseases (CVDs) are currently the leading cause of mortality worldwide, with coronary heart disease being the primary cause. The Mediterranean Diet (MD) has been highlighted for its potential in providing greater protection against CVDs. This study aims to present an updated systematic review that examines the impact of MD on mortality and CVDs, both in the general population and in patients with a prior CVD, while also considering the potential influence of gender. We conducted a systematic review. After the selection process, 24 studies met the inclusion criteria. The findings from these studies consistently demonstrate that higher adherence to the MD is associated with a reduced risk of overall mortality, both in the general population and in patients with previous CVDs. Moreover, evidence suggests that following this dietary pattern likely decreases the risk of CVDs such as heart attacks, various types of coronary artery disease, stroke, and cardiovascular mortality. While some studies have identified differences in the benefits of the MD between men and women, it is important to note that these disparities may be attributed to lower event rates and a generally lower cardiovascular risk profile in women. Thus, the observed variations in outcomes should be interpreted in the context of these factors. Adherence to the MD has the potential to improve survival rates and reduce the risk of CVDs in both the general population and individuals with a prior CVD. Further research is needed to explore the specific mechanisms underlying the protective effects of this dietary pattern and to better understand the role gender-related differences in its outcomes. Nevertheless, promoting the adoption of the MD could be an effective strategy for mitigating the burden of CVDs globally.

NANDA nursing diagnoses associated with the occurrence of psychomotor agitation in patients with severe mental disorder: a cross-sectional study.

BACKGROUND: Psychomotor agitation is increased psychomotor activity, restlessness and irritability. People with psychomotor agitation respond by overreacting to intrinsic and extrinsic stimuli, experiencing stress and/or cognitive impairment. the aim was to analyse the association of nursing diagnoses with the disinhibition dimension, the aggressiveness dimension and the lability dimension of the Corrigan Agitated Behaviour Scale. METHODS: This study was conducted in Spain using a multicentre cross-sectional convenience sample of 140 patients who had been admitted to psychiatric hospital units and had presented an episode of psychomotor agitation between 2018 and 2021. RESULTS: The Corrigan Agitated Behaviour Scale was used to assess psychomotor agitation. Associated nursing diagnoses, violence directed at professionals and the environment are shown to be predictive values for the severity of the agitation episode. Moderate-severe psychomotor agitation episodes are shown as predictors of violence directed mainly at professionals and the environment. CONCLUSIONS: There is an urgent need for mental health nurses to have knowledge of the extended clinic in order to care for users and improve their health conditions in dealing with people, with their social, subjective and biological dimension.

Formal and Informal Services Used by Women Who Suffer Intimate Partner Violence in Spain.

Intimate partner violence (IPV) is an important public health problem. Female victims of IPV do not always use the institutional resources available to them. We conducted a cross-sectional study using data from the Spanish 2014 Macro-Survey on Violence Against Women. The findings show that 15% of the survey participants suffered from IPV in the last year. The factors associated with a higher probability of suffering IPV are being of non-Spanish nationality, being a student, having a low-educational level, having no income, being the household head, and not having a current partner. Regarding the resources used by women subjected to IPV, almost half resorted to informal sources, such as female friends and/or their own mothers. The use of formal resources was low. Therefore, IPV continues to be a problem in Spain that seems to remain in the private domain. Consequently, it is necessary to increase the availability of and access to legal resources.

Quantitative analysis of the obturation of oval-shaped canals using thermoplastic techniques.

Background: One of the aim of root canal treatment is filling the root canals in a 3D way. It is not always possible to achieve due to the existence of anatomical variations. The obturation of oval canal usually provides great difficulties. Its complex anatomy can cause obstacles in instrumentation, irrigation and obturation. Aim: The main aim of this study is to quantify the area filled by gutta-percha, the area filled by cement and the area of voids present in oval canals, treated by thermoplastic filling techniques in comparison with the lateral condensation technique and observe the adaptation of the gutta-percha to the anatomy of the oval root canals according to the obturation technique. Material and Methods: 80 mandibular incisors were selected. The teeth were instrumented with Protaper Gold® and divided into 4 groups of 20. Group 1 was filled with Thermafill®; group 2 with GuttaCore®; group 3 with continuous wave vertical condensation and group 4 with the lateral condensation technique. Two horizontal sections were cut at 5mm and 7mm from the apex and they were set in putty silicone. The samples were analyzed with a Leica DMS 1000 digital microscope and processed with Leica Suite for Windows XP. The area of gutta-percha, cement and voids and the percentages, of each one, were calculated. A statistical analysis was performed using the T-Student, ANOVA tests and Kruskal-Wallis tests. Results: All thermoplastic techniques achieved a high percentage of obturation. The percentages of voids in group 4 were the highest. Statistically significant differences were found between thermoplastic techniques compared with lateral condensation. Conclusions: Thermoplastic techniques achieve better adaptation of the gutta-percha in the oval canals and low amount of cement and voids in the middle and coronal thirds respect to the lateral condensation group. Moreover, comparing termoplasthicized techniques among them, continuous wave vertical condensation got the lowest percentage of voids. Key words:Warm gutta-percha, thermoplastic obturation, oval canals, oval-shaped canals.

Life cycle assessment of routinely used endoscopic instruments and simple intervention to reduce our environmental impact.

OBJECTIVES: GI endoscopy units represent the third largest producers of medical waste. We aimed to determine endoscopic instrument composition and life cycle assessment (LCA) and to assess a sustainability proposal based on a mark on the instruments that identifies parts can be safely recycled or 'green mark'. DESIGN: Material composition analysis and LCA of forceps, snares and clips from four different manufacturers (A-D) were performed with four different methods. Carbon footprint from production, transportation and end of life of these instruments was calculated. In 30 consecutive procedures, we marked the contact point with the working channel. 5 cm away from that point was considered as green mark. One-week prospective study was conducted with 184 procedures evaluating 143 instruments (75 forceps, 49 snares and 19 haemoclips) to assess the efficacy of this recyclable mark. RESULTS: Composition from different manufacturers varied widely. Most common materials were high global warming potential (GWP) waste (polyethylene, polypropylene and acrylonitrile) and low GWP waste (stainless steel). Significant differences were found for the forceps (0.31-0.47 kg of CO2 equivalent (CO2-eq)) and haemoclips (0.41-0.57 kg CO2-eq) between the manufacturers. Green mark was established 131.26 cm for gastroscope and 195.32 cm for colonoscope. One-week activity produced 67.74 kg CO2-eq. Applying our sustainability intervention, we could reduce up to 27.44% (18.26 kg CO2-eq). This allows the recycling of 61.7% of the instrument total weight (4.69 kg). CONCLUSION: Knowledge of carbon footprint is crucial to select the most sustainable alternatives because there are large variations between brands. A mark to identify recyclable parts could reduce our environmental impact significantly.

Tratamiento de la macromastia sintomática en una unidad de mama. Resultados de la reducción mamaria evaluados mediante el cuestionario BREAST-Q / Treatment of symptomatic macromastia in a breast unit. Outcomes analysis of breast reduction using BREAST-Q

Introducción: El BREAST-Q (módulo reducción mamaria) es un cuestionario específico y validado para evaluar la reducción mamaria en el tratamiento de la macromastia sintomática, ofreciendo información sobre la calidad de vida y grado de satisfacción de las pacientes. Métodos: Estudio prospectivo de una cohorte de 34 pacientes tratadas mediante reducción mamaria bilateral, en una unidad de mama en 2017-2020, que fueron encuestadas con la versión adaptada al castellano del BREAST-Q. Las pacientes cumplimentaron el cuestionario en el mes previo a la cirugía y después de esta. Los cambios de las puntuaciones pre- y postoperatorias en los diferentes dominios se analizaron mediante la prueba de rangos con signo de Wilcoxon. La significación estadística fue determinada con valores de p<0,05. Resultados: El tiempo medio desde la cirugía a la encuesta postoperatoria fue 16 (DE 9) meses. Complicaciones o secuelas posquirúrgicas sucedieron en 14 (42%) pacientes con 23 eventos. Las puntuaciones preoperatorias, medianas y rango intercuartílico, en la satisfacción con las mamas (28, 26), bienestar psicológico (33, 14), físico (42, 19) y sexual (34, 14) mejoraron en la encuesta postoperatoria a (82, 15), (81,29), (82, 30) y (90, 38), respectivamente, con significación estadística, p<0,001. Conclusiones: La primera aplicación del BREAST-Q versión en castellano para españolas a pacientes con macromastia tratadas quirúrgicamente en una unidad de mama demuestra que la reducción mamaria mejora la calidad de vida de las pacientes y, que estas están muy satisfechas con el resultado de la cirugía y su cirujano, aunque la información recibida es mejorable. (AU)

Introduction: The BREAST-Q (breast reduction module) is a specific and validated questionnaire to evaluate breast reduction in the treatment of symptomatic macromastia, offering information on their quality of life and degree of satisfaction. Methods: Prospective study of a cohort of 34 patients treated by bilateral breast reduction in a breast unit in 2017–2020 surveyed with the Spanish version of BREAST-Q version 2. The statistical study to assess the effect of reduction, changes from the pre to postoperative scores of the domains were performed using the Wilcoxon signed rank test. Statistical significance was determined with P values <.05. Results: The mean time elapsed from surgery to the postoperative survey was 16 (SD 9) months. Post-surgical complications or sequelae occurred in 14 (42%) patients with 23 events. The preoperative scores, median and interquartile range, in satisfaction with the breasts (28, 26), psychological (33, 14), physical (42, 19) and sexual (34, 14) well-being improved in the postoperative survey to (82, 15), (81, 29), (82, 30) and (90, 38), respectively. These changes were statistically significant, P<.001. Conclusions: The first application of the BREAST-Q in its version in Spanish for Spanish women in patients with symptomatic macromastia treated surgically in a breast unit shows that breast reduction improves the quality of life of patients and that they are very satisfied with the outcome of the surgery and its surgeon, although the information received should clearly be improved. (AU)

Influence of state of health and personality factors of resilience and coping in healthy subjects and those with diabetes.

Introduction: Currently, the most common chronic metabolic disease in our society is Diabetes Mellitus. The diagnosis of Diabetes Mellitus supposes an impact for the patient, since it requires a modification in the lifestyle, which demands a great capacity for adaptation and modification of habits. The aim of the study was to determine whether personality factors and health status influence resilience and coping strategies in a sample of healthy and diabetic subjects. Methodology: The sample included a total of 401 subjects (201 patients with Diabetes and 200 without pathology). The instruments applied for data collection were: Sociodemographic data questionnaire, the Resilience Scale, the Coping Strategies Questionnaire and The "Big Five" factor taxonomy. The data collection period was approximately 2 years (between February 2018 and January 2020). Results: Certain personality factors, such as Emotional Stability, Integrity, Conscientiousness and Extraversion, were positively related to Resilience. Additionally, Emotional Stability, Integrity, and Extraversion were positively associated with Rational Coping. On the other hand, emotional stability, agreeableness and extraversion were negatively related to emotional coping. In relation to health status, the absence of pathology is related to the use of rational strategies more than to the diagnosis of diabetes. Therefore, the participants in this study present different psychological patterns depending on personality and health status. Conclusions: The present study shows that the subjects of the sample present different psychological patterns depending on Personality and health status.

Factors Associated with Adherence to Treatment in Patients with HIV and Diabetes Mellitus.

We aim to identify the factors that influence the therapeutic adherence of subjects with chronic disease. The design followed in this work was empirical, not experimental, and cross-sectional with a correlational objective. The sample consisted of a total of 400 subjects (199 patients with HIV and 201 patients with diabetes mellitus). The instruments applied for data collection were a sociodemographic data questionnaire, the 4-item Morisky Medication Adherence Scale (MMAS-4) and the Coping Strategies Questionnaire. In the group of subjects with HIV, that the use of emotional coping strategies was related to lower adherence to treatment. On the other hand, in the group of subjects with diabetes mellitus, the variable related to compliance with treatment was the duration of illness. Therefore, the predictive factors of adherence to treatment were different in each chronic pathology. In the group of subjects with diabetes mellitus, this variable was related to the duration of the disease. In the group of subjects with HIV, the type of coping strategy used predicted adherence to treatment. As a result of these results, it is possible to develop health programmes to promote, from nursing consultations to adherence to treatment of patients with HIV and diabetes mellitus.

Treatment of symptomatic macromastia in a breast unit. Outcomes analysis of breast reduction using BREAST-Q.

INTRODUCTION: The BREAST-Q (breast reduction module) is a specific and validated questionnaire to evaluate breast reduction in the treatment of symptomatic macromastia, offering information on their quality of life and degree of satisfaction. METHODS: Prospective study of a cohort of 34 patients treated by bilateral breast reduction in a breast unit in 2017-2020 surveyed with the Spanish version of BREAST-Q version 2. The statistical study to assess the effect of reduction, changes from the pre to postoperative scores of the domains were performed using the Wilcoxon signed rank test. Statistical significance was determined with p values ​​<0.05. RESULTS: The mean time elapsed from surgery to the postoperative survey was 16 (SD 9) months. Post-surgical complications or sequelae occurred in 14 (42%) patients with 23 events. The preoperative scores, median and interquartile range, in satisfaction with the breasts (28, 26), psychological (33, 14), physical (42, 19) and sexual (34, 14) well-being improved in the postoperative survey to (82, 15), (81.29), (82, 30) and (90, 38), respectively. These changes were statistically significant, p < 0.001. CONCLUSIONS: The first application of the BREAST-Q in its version in Spanish for Spanish women in patients with symptomatic macromastia treated surgically in a breast unit shows that breast reduction improves the quality of life of patients and that they are very satisfied with the outcome of the surgery and its surgeon, although the information received should clearly be improved.