High Glucose Promotes Inflammation and Weakens Placental Defenses against E. coli and S. agalactiae Infection: Protective Role of Insulin and Metformin.

Placentas from gestational diabetes mellitus (GDM) patients undergo significant metabolic and immunologic adaptations due to hyperglycemia, which results in an exacerbated synthesis of proinflammatory cytokines and an increased risk for infections. Insulin or metformin are clinically indicated for the treatment of GDM; however, there is limited information about the immunomodulatory activity of these drugs in the human placenta, especially in the context of maternal infections. Our objective was to study the role of insulin and metformin in the placental inflammatory response and innate defense against common etiopathological agents of pregnancy bacterial infections, such as E. coli and S. agalactiae, in a hyperglycemic environment. Term placental explants were cultivated with glucose (10 and 50 mM), insulin (50-500 nM) or metformin (125-500 µM) for 48 h, and then they were challenged with live bacteria (1 × 105 CFU/mL). We evaluated the inflammatory cytokine secretion, beta defensins production, bacterial count and bacterial tissue invasiveness after 4-8 h of infection. Our results showed that a GDM-associated hyperglycemic environment induced an inflammatory response and a decreased beta defensins synthesis unable to restrain bacterial infection. Notably, both insulin and metformin exerted anti-inflammatory effects under hyperglycemic infectious and non-infectious scenarios. Moreover, both drugs fortified placental barrier defenses, resulting in reduced E. coli counts, as well as decreased S. agalactiae and E. coli invasiveness of placental villous trees. Remarkably, the double challenge of high glucose and infection provoked a pathogen-specific attenuated placental inflammatory response in the hyperglycemic condition, mainly denoted by reduced TNF-α and IL-6 secretion after S. agalactiae infection and by IL-1ß after E. coli infection. Altogether, these results suggest that metabolically uncontrolled GDM mothers develop diverse immune placental alterations, which may help to explain their increased vulnerability to bacterial pathogens.

Delving into the Determinants of Default Risk in Savings Groups: Empirical Evidence from Ecuador.

Financial inclusion has been broadly recognized as critical in alleviating poverty and achieving inclusive economic growth. The capability of borrowers to repay their microcredit loans is a critical concern and is the first risk of Microfinance institutions sustainability. Exploring the determinants of credit risk is an issue of substantial importance in microfinance. The purpose of this research was to identify the savings group members' characteristics that have impact on default risk. We have used a multivariate regression model to identify the factors that affect default behaviour among microcredit borrowers from savings groups. We have analysed a sample of more than different 400 Savings Groups and 7251 active users of the "Saving and Learning" program in Ecuador. Empirical results demonstrated that factors such as seniority, accumulated savings and the number of members in the savings groups are determinant variables of default risk. The significant positive sign on variable "Gender" is consistent with the previous authors that indicate that the probability of having problems in loan repayment is higher for males than for females. The generalizability of our findings should, of course, be interpreted with caution, as they may be idiosyncratic of the sample, period or region. To contrast and contextualize these results, we had in-depth discussions with the Savinco managers and their field agent in Ecuador. There are many contributions. For practitioners, relevant factors that can affect savings groups default rates have been identified. For academics, the rich information provided by the Savinco mobile App could be a starting point for further quantitative research.

Il est largement reconnu que l'inclusion financière est essentielle pour réduire la pauvreté et parvenir à une croissance économique inclusive. La capacité des emprunteurs à rembourser leurs prêts de microcrédit est une préoccupation essentielle et constitue le premier risque pour la pérennité des institutions de microfinance. L'étude des déterminants du risque de crédit est une question d'une importance capitale en microfinance. Le but de cette étude est d'identifier les caractéristiques des membres de groupes d'épargne qui ont un impact sur le risque de défaut de paiement. Nous avons utilisé un modèle de régression multivariée pour identifier les facteurs qui affectent le comportement de défaut de paiement parmi les emprunteurs de microcrédit au sein de groupes d'épargne. Nous avons analysé un échantillon de plus de 400 groupes d'épargne différents et 7 251 utilisateurs actifs du programme « Épargne et apprentissage ¼ en Équateur. Les résultats empiriques ont démontré que des facteurs tels que l'ancienneté, l'épargne accumulée et le nombre de membres dans les groupes d'épargne sont des variables déterminantes du risque de défaut de paiement. Sur la variable « Genre ¼, le signe positif significatif est cohérent avec les études précédentes qui indiquent que la probabilité d'avoir des problèmes de remboursement de prêt est plus élevée chez les hommes que chez les femmes. Bien entendu, le caractère généralisable de nos résultats doit être interprété avec prudence, car ces résultats peuvent être uniques à l'échantillon, à la période ou à la région. Pour contraster et contextualiser ces résultats, nous avons eu des discussions approfondies avec les gestionnaires de Savinco et leur agent de terrain en Équateur. Les contributions sont nombreuses. Pour les praticiens, ont été identifiés les facteurs pertinents pouvant affecter le taux de défaut de paiement des groupes d'épargne. Pour les universitaires, les riches informations fournies par l'application mobile Savinco pourraient être un point de départ pour d'autres études quantitatives.

Enfermedad relacionada con IgG4: reporte de un caso y revisión de la literatura / IgG4-related disease: a case report and literature review

Immunoglobulin G4 (IgG4-RD) -related disease is a regional or systemic fibroinflammatory disease of unknown etiology. It has a characteristic histopathological appearance of dense lymphoplasmacytic infiltrates with abundant IgG4 positive plasma cells, storiform fibrosis and obliterative phlebitis with the appearance of inflammatory swelling or swollen lesions. This entity frequently affects the pancreas, salivary glands, and lymph nodes, but it can compromise almost any structure in the human anatomy. This new disease entity includes a wide variety of diseases such as Mikulicz disease, autoimmune pancreatitis, Riedel's thyroiditis, interstitial nephritis, and retroperitoneal fibrosis. Glucocorticoid therapy can resolve clinical and pathologic abnormalities and impaired organ function. IgG4-RD was internationally recognized in 2011, and new evidence has accumulated on its pathogenesis, clinical characteristics, and treatment. However, much is still unknown about the behavior of IgG4 in vivo, the participation of this molecule in disease, and whether its role in IgG4-related disease is primary or secondary. The text below is based on a brief review of the most recent literature on this entity in relation to a clinical case.

Fenotipos clínicos en el síndrome de apnea obstructiva del sueño / Clinical phenotypes in obstructive sleep apnea

El síndrome de apnea e hipopnea obstructiva del sueño se caracteriza por episodios repetitivos de obstrucción de vía aérea superior y es reconocida cada vez más, como un trastorno heterogéneo y complejo, proponiéndose múltiples fenotipos en base a su mecanismo patogénico, alteraciones polisomnográficas y la presentación clínica. El fenotipo clínico se enfoca en identificar características de un paciente basándose en signos, síntomas, antropometría, comorbilidades, medidas fisiológicas, anatómicas o respuesta al tratamiento. Al ser una enfermedad sub diagnosticada, de alta prevalencia y que produce elevada morbi-mortalidad, se debe estar atento a la pesquisa precoz y en las poblaciones de riesgo. Su diagnóstico se basa en el índice de apnea-hipopnea (IAH) y se requiere un IAH •5 eventos/hora para confirmar el diagnóstico. Sin embargo, cada vez hay más evidencia que el IAH por sí solo es insuficiente para comprender la presentación clínica, respuesta al tratamiento, calidad de vida y mortalidad de los pacientes con apnea del sueño. El fenotipo clínico puede servir de este modo, para entender mejor las diferentes formas de presentación teniendo como finalidad la medicina personalizada con el objetivo de favorecer la conducta terapéutica individualizada. El objetivo de esta revisión es abordar los fenotipos clínicos y proponer una huella digital en los pacientes con apnea del sueño

Obstructive sleep apnea and hypopnea syndrome is characterized by repetitive episodes of upper airway obstruction and is increasingly recognized as a heterogeneous and complex disorder, proposing multiple phenotypes based on its pathogenic mechanism, polysomnographic alterations, and clinical presentation. The clinical phenotype focuses on identifying a patient's characteristics based on signs, symptoms, anthropometry, comorbidities, physiological, anatomical measures or response to treatment. As it is an underdiagnosed disease of high prevalence associated to high morbidity and mortality, we must be alert to early screening and risk populations. Diagnosis is based on the apnea-hypopnea index (AHI) AHI •5 events/hour is required to confirm it, however, there is increasing evidence that AHI alone is insufficient to understand the clinical presentation, the response to treatment, the quality of life and the mortality of patients with sleep apnea. In this way, the clinical phenotype can serve to better understand the different forms of presentation and looks for a personalized medicine that favors an individualized therapeutic behavior. The aim of this review is to address clinical phenotypes and propose a fingerprint in patients with sleep apnea

Intervención médica invasiva comparada con la intervención conservadora en el tratamiento de varicosidades en mujeres gestantes: Evaluación rápida de la evidencia / Invasive medical intervention compared with conservative intervention in the treatment of varicose veins in pregnant women: Rapid evaluation of the evidence / Intervenção médica invasiva em comparação com intervenção conservadora no tratamento de varizes em mulheres grávidas: avaliação rápida da evidência

Resumen El objetivo de este estudio fue analizar la mejor evidencia científica disponible relacionada con la intervención médica conservadora comparada con la intervención más invasiva incluyendo la quirúrgica para el tratamiento de venas varicosas en miembros inferiores durante el embarazo y la prevención de la aparición posterior. Inició con Se aplicó la metodología de evaluación rápida de la evidencia. Se llevó a cabo una búsqueda de literatura en las bases de datos, sin límite de fechas. Criterios de inclusión: Gestantes con patología varicosa en miembros inferiores de cualquier edad. Los tipos de estudios analizados fueron Revisiones Sistemáticas, ECA, Meta-análisis o Guías de Práctica Clínica en inglés, portugués o español. Se utilizó la plataforma FLC 2.0 y Agree II para el análisis y la plantilla de Sackett para la interpretación de niveles de evidencia y grados de recomendación. Se recuperaron 322 artículos, se seleccionaron tres. Se obtuvo que la intervención recomendada es la terapia conservadora, solo en casos excepcionales se determinará otra intervención. El tratamiento invasivo incluyendo el quirúrgico, se reserva para casos delicados ya que los riesgos superan los beneficios. Se concluye que el tratamiento de primera línea para el tratamiento de varicosidades en gestantes son las medias de compresión. Los rutósidos y anticoagulantes orales parecen ayudar pero no es seguro de utilizar durante el embarazo.

Abstract The objective of this study was to analyze the best available scientific evidence related to conservative medical intervention compared to the most invasive intervention including surgery for the treatment of varicose veins in the lower limbs during pregnancy and the prevention of subsequent onset. It started with The rapid evidence evaluation methodology was applied. A search of literature in the databases was carried out, with no date limit. Inclusion criteria: Pregnant women with varicose pathology in lower limbs of any age. The types of studies analyzed were Systematic Reviews, RCTs, Meta-analysis or Clinical Practice Guidelines in English, Portuguese or Spanish. The FLC 2.0 and Agree II platform was used for the analysis and the Sackett template for the interpretation of levels of evidence and grades of recommendation. 322 items were retrieved, three were selected. It was obtained that the recommended intervention is conservative therapy, only in exceptional cases will another intervention be determined. Invasive treatment, including surgical treatment, is reserved for sensitive cases since the risks outweigh the benefits. It is concluded that the first line treatment for the treatment of varicose veins in pregnant women is compression stockings. Routine and oral anticoagulants seem to help but it is not safe to use during pregnancy.

Resumo O objetivo deste estudo foi analisar as melhores evidências científicas disponíveis relacionadas à intervenção médica conservadora em comparação com a intervenção mais invasiva, incluindo cirurgia para o tratamento de varizes nos membros inferiores durante a gravidez e a prevenção de subsequente aparecimento. Começou com A metodologia de avaliação rápida de evidências foi aplicada. Foi realizada uma pesquisa bibliográfica nas bases de dados, sem data limite. Critérios de inclusão: Gestantes com patologia varicosa em membros inferiores de qualquer idade. Os tipos de estudos analisados foram Revisões Sistemáticas, ECR, Meta-análise ou Diretrizes de Prática Clínica em inglês, português ou espanhol. A plataforma FLC 2.0 e Agree II foi utilizada para a análise e o modelo de Sackett para a interpretação dos níveis de evidência e graus de recomendação. 322 itens foram recuperados, três foram selecionados. Foi obtido que a intervenção recomendada é terapia conservadora, apenas em casos excepcionais será determinada outra intervenção. O tratamento invasivo, incluindo o tratamento cirúrgico, é reservado para casos sensíveis, pois os riscos superam os benefícios. Conclui-se que o tratamento de primeira linha para o tratamento de varizes em gestantes são as meias de compressão. Anticoagulantes de rotina e orais parecem ajudar, mas não é seguro para uso durante a gravidez.

Generalidades de las venas varicosas en miembros inferiores y su tratamiento durante el embarazo: una revisión narrativa / Generalities regarding varicose veins in lower limbs and their treatment during pregnancy: a narrative review / Generalidades das varizes em membros inferiores e seu tratamento durante a gravidez: uma revisão narrativa

Resumen 20. La enfermedad varicosa es un problema común que afecta a gran parte de la población mundial, principalmente en mujeres, agravado por una condición de embarazo. Esta revisión narrativa tiene el objetivo de conocer la evidencia científica disponible sobre aspectos diagnósticos, factores de riesgo e intervención conservadora o invasiva, incluyendo cirugía de las venas varicosas en miembros inferiores en mujeres embarazadas. La búsqueda bibliográfica se llevó a cabo en las bases de datos PubMed, Biblioteca Cochrane y EBSCO Host entre los años 2009 y 2017. Se recuperó 50 referencias bibliográficas y se seleccionó seis documentos para el análisis. Respecto del diagnóstico se lleva a cabo mediante la observación, examen directo, historia clínica y exámenes más específicos como el doppler. La síntomatología más común que se presenta es el dolor en miembros inferiores, edema, pesadez, prurito y calambres. La intervención para el tratamiento a mujeres embarazadas es la terapia conservadora, aunque solo en casos excepcionales se determinará otro tipo de tratamiento. En este proceso, la educación tiene un rol muy importante en la seguridad de la madre y el feto, cuyo abordaje debe ser dado por un equipo de profesionales en salud. Se concluye que existe controversias respecto de la patogenia de esta morbilidad durante el embarazo, por lo tanto, no se ofrece otros tratamientos distintos a los recomendados desde el año 50, de manera que hay una gran necesidad de llevar a cabo estudios robustos que demuestren cuáles son las mejores medidas profilácticas más novedosas y de tratamiento desde el inicio del embarazo, además de promover la prevención de la aparición posterior, de tal manera que esté asegurada la salud de la mujer y, consecuentemente, la de su bebé.

Abstract 24. The varicose disease is a common problem that affects a large part of the world population in greater percentage of women, added to its condition the presence of pregnancy. This narrative review has the objective of knowing the available scientific evidence on diagnostic aspects, risk factors and conservative or invasive intervention including surgery of varicose veins in lower limbs in pregnant women. The bibliographic search was carried out in PubMed, Cochrane Library and EBSCO Host databases between 2009 and 2017. Fifty bibliographical references were retrieved and six documents were selected for analysis. Regarding the diagnosis is carried out through observation, direct examination, clinical history, more specific examinations such as Doppler. The most common symptom presented is a pain in the lower limbs, oedema, heaviness, pruritus and cramps. The intervention for the treatment of pregnant women is conservative therapy, only in exceptional cases will be determined another type of treatment. Education plays a very important role in the safety of the mother and the fetus. The approach to these women must be given by a team of health professionals. It is concluded that there are controversies regarding the pathogenesis of this morbidity during pregnancy and, therefore, no treatments other than those recommended since year 50 are offered, so there is a great need to carry out robust studies that show which are the best new prophylactic measures and treatment from the beginning of pregnancy, in addition to promoting the prevention of subsequent appearance, in such a way that the health of the woman and consequently that of her baby is ensured.

Resumo 28. A doença varicosa é um problema comum que afeta uma grande parte da população mundial em maior porcentagem para as mulheres, adicionou à sua condição a presença de gravidez. Esta revisão narrativa tem como objetivo conhecer as evidências científicas disponíveis sobre aspectos diagnósticos, fatores de risco e intervenção conservadora ou invasiva, incluindo cirurgia de varizes em membros inferiores em mulheres grávidas. A pesquisa bibliográfica foi realizada nas bibliotecas PubMed, Cochrane Library e EBSCO Host entre 2009 e 2017. Cinquenta referências bibliográficas foram recuperadas e 6 documentos foram selecionados para análise. Quanto ao diagnóstico é realizado através da observação, exame direto, história clínica, exames mais específicos, como Doppler. O sintoma mais comum apresentado é a dor nos membros inferiores, edema, peso, prurido e cólicas. A intervenção para o tratamento de mulheres grávidas é a terapia conservadora, apenas em casos excepcionais será determinado outro tipo de tratamento. A educação desempenha um papel muito importante na segurança da mãe e do feto. A abordagem dessas mulheres deve ser dada por uma equipe de profissionais de saúde. Conclui-se que há controvérsias quanto à patogenia desta morbidade durante a gravidez e, portanto, não são oferecidos outros tratamentos além dos recomendados desde o ano 50, por isso há uma grande necessidade de realizar estudos robustos que mostrem quais são as melhores medidas profiláticas novas e o tratamento desde o início da gravidez, além de promover a prevenção da aparição subseqüente, de tal forma que seja assegurada a saúde da mulher e conseqüentemente a de seu bebê.

Sertraline-induced Hemichorea.

Background: Hemichorea-hemiballism is a syndrome secondary to different etiologies. Drug-induced hemichorea is a rare syndrome related to selective serotonin reuptake inhibitors. To the best of our knowledge, no previous cases of hemichorea associated with sertraline have been reported. Case Report: A 65-year-old female noticed hemichorea 1 week after initiation of sertraline. After extensive investigations, other causes of hemichorea were excluded. Hemichorea remitted after sertraline withdrawal. Discussion: In our patient, temporal association and the negative clinical assessment supported a diagnosis of likely drug-induced involuntary movement. We hypothesized that enhanced serotonergic transmission in the ventral tegmental area or nigrostriatum may be involved in sertraline-induced hemichorea.

Budget impact of secondary hyperparathyroidism treatment in chronic kidney disease in an Ecuadorian social security hospital.

BACKGROUND: Chronic kidney disease (CKD) is a disorder with high morbidity and mortality worldwide whose complications generate multiple costs. In Ecuador, only a few healthcare institutions have implemented management protocols aimed to reduce costs and to improve the quality of life of patients. The aim of this study is to evaluate the short-term (1-year) and long-term (5-year) costs and savings in the management of secondary hyperparathyroidism (SHPT) of hemodialyzed CKD patients by comparing calcitriol and paricalcitol in a large social security hospital in Quito, Ecuador. METHODS: The estimation model assessed the resources used in the management of SHPT by comparing prospectively the cost savings within 1-year and 5-year time horizon with calcitriol and paricalcitol. Hospitalization, erythropoietin (EPO), treatment doses, intravenous iron consumption, and medical supplies were estimated according international references, based on the initial parathormone level (iPTH) of patients. The Ecuadorian National Reference costs (2014-2015) and institutional costs were used to calculate treatment costs. A statistical sensitivity analysis was also performed. RESULTS: The study was based on data from 354 patients of whom 147 (41.4 %) had a value of iPTH in the range 300-600 pg/ml, 45 (12.8 %) in the range 601-800 pg/ml, and 162 (45.7 %) over 800 pg/ml. The 1-year estimated costs per patient for calcitriol and paricalcitol, respectively, were: medication, 63.88 USD and 1,123.44 USD; EPO, 19,522.95 USD and 16,478 USD; intravenous iron 143.21 USD and 187.76 USD. Yearly hospitalization costs per patient were 11,647.99 USD with calcitriol and 8,019.41 USD with paricalcitol. Total yearly costs per patient amounted to 31,378.02 USD with calcitriol and 25,809.50 USD with paricalcitol. Total savings using paricalcitol were 5,568.52 USD per patient compared with calcitriol. The 5-year cumulative medication costs were 319 USD for calcitriol and 2,403 USD for paricalcitol; EPO with calcitriol was 97,615 USD and with paricalcitol 82,394 USD; intravenous iron with calcitriol was 716 USD and paricalcitol 939 USD. Hospitalization costs for patients with calcitriol and paricalcitol were 43,095 USD and 62,595 USD, respectively. Total savings using paricalcitol amounted 32,414 USD per patient compared with calcitriol. CONCLUSIONS: Paricalcitol use generated more cost savings than calcitriol after 1 and 5 years.

Anestesia tópica en la cirugía de estrabismo / Topical anesthesia in strabismus surgery

Definimos la anestesia tópica asistida en la cirugía de estrabismo como la asociación de sedación o analgesia por vía sistémica y la administración de anestésicos por vía tópica. La anestesia tópica ha permitido modificar el procedimiento quirúrgico de las suturas ajustables en el tratamiento del estrabismo. Los criterios de selección de pacientes, músculos, y técnicas quirúrgicas han ido aumentado con el tiempo, pero se debe descartar a los enfermos que tengan menos de 14 años, aquellos con enfermedades mentales graves, y operados previamente de retina. Las ventajas del ajuste intraoperatorio son: mayor comodidad del paciente, control anestésico, menor riesgo potencial de infecciones, disminución del número de músculos que deben ser operados, conocer la posición exacta de los músculos después del ajuste, y una menor estadía hospitalaria. En diferentes estudios realizados con anestesia tópica en nuestro departamento hemos tenido buenos resultados, tanto en el posoperatorio inmediato (90%), como a los seis meses de la cirugía (85%), con una baja tasa de reintervenciones (15%), la mayoría por hipocorrección quirúrgica, y una elevada satisfacción y tolerancia a la realización de la cirugía con anestesia tópica. Podemos concluir que este procedimiento ha permitido modificar la cirugía de los músculos extraoculares en la actualidad, evitando los inconvenientes de la anestesia general, y disminuyendo el costo de las operaciones de estrabismo al convertir la cirugía en un procedimiento ambulatorio.

Topical anesthesia in strabismus surgery is defined as a procedure that includes the use of systemic analgesics and/or sedatives in combination with local anesthetics. Topical anesthesia has favored the modification of adjustable sutures in strabismus surgery. The selection criteria of patients, muscles, and surgical techniques have become stricter over time; however this approach is not appropriate for patients younger than 14 years of age, those with severe mental disease and those with prior retinal surgery. Topical anesthesia strabismus surgery using adjustable sutures has many advantages, such as greater patient comfort, anesthetic control, lower risk of infections, reduced number of intervened muscles, better control of muscle alignment and shorter hospital and recovery time. The results of different studies performed on topical anesthesia in our department produced a favorable outcome for strabismus surgery in the early postoperative period (90%) as well as 6 months after surgery (85%), lower rate of reoperations (15%), mostly for surgical hypocorrection, and higher patient satisfaction and tolerance. In conclusion, topical anesthesia has improved the treatment of extraocular muscle pathology, avoiding the drawbacks related to general anesthesia and reducing the cost of strabismus surgery.

Exploring the Use of information and communication technologies and social networks among university nursing faculty staff. An opinion survey.

OBJECTIVE: This work sought to analyze the use of Information and Communication Technologies (ICTs) and social networks among the university nursing faculty staff in Spain. METHODOLOGY: This was a descriptive, cross-sectional study using a questionnaire on ICT skills designed to comply with the research objective, which was evaluated by experts and which was subjected to exploratory analysis of principal components; the reliability of this instrument measured with Cronbach's alpha was 0.85. The information technology tool used to publish the questionnaire on line was Limesurvey. The sample comprised 165 professors from 25 Nursing Faculties and Schools from universities in Spain. RESULTS: Seventy one percent of the total surveyed used internet services to look for information, 63% used the internet as a means for formation and learning, and 72% used it as a communication platform (e-mail and virtual platforms like Sakai and Moodle). Although 51% of the teaching staff surveyed had more than 120 students registered in their courses, hypothesis testing revealed that the number of students in class is not a determining factor for the teaching staff to have greater interest to update its knowledge in ICTs. Younger professors use new technologies more profusely and the most-valued advantage of using ICTs was quick access to information. Professors perceive that after the Bologna Declaration, which requires modifying their teaching-learning processes through the new teaching methodologies, a drop has been produced in their performance and that of their peers in their area of knowledge. CONCLUSION: The nursing teaching staff is making strong efforts to confront the new challenges posed by ICTs to train the professionals of the 21st century. It is fundamental to pay special attention to improving the university teaching staff's skills in managing ICTs, promoting the implementation of the knowledge acquired.

Uso de las Tecnologías de la información y la comunicación y las redes sociales entre el profesorado universitario de enfermería / Explorando o uso das Tecnologias da informação e a comunicação e as redes sociais entre o professorado universitário de enfermagem. Uma enquete de opinião / Exploring the Use of information and communication technologies and social networks among university nursing faculty staff. An opinion survey

Objetivo. Analizar el uso de las Tecnologías de la información y la comunicación –TIC- y las redes sociales entre el profesorado universitario de enfermería en España. Metodología. Estudio descriptivo de corte transversal en el que se empleó un cuestionario sobre competencias TIC diseñado para cumplir con el objetivo de investigación, el cual fue evaluado por expertos. Posteriormente, se le hizo análisis exploratorio de componentes principales. La confiabilidad de este instrumento fue 0.85, medida con el alfa de Cronbach. La herramienta informática utilizada para publicar en línea el cuestionario fue Limesurvey. La muestra estuvo compuesta por 165 profesores de 25 Facultades y Escuelas de Enfermería de las Universidades de España. Resultados. El 71% del total de encuestados utilizaba los servicios de Internet para buscar información, el 63% hacía uso de Internet como vía de formación y aprendizaje y un 72% lo empleaba como plataforma de comunicación (correo electrónico y plataformas virtuales como Sakai y Moodle). A pesar de que el 51% del profesorado encuestado tenía más de 120 alumnos matriculados en sus cursos, un contraste de hipótesis reveló que el número de alumnos en clase no es un factor determinante para que el profesorado tenga mayor interés por actualizar sus conocimientos en TIC. Los profesores más jóvenes utilizan con mayor profusión las nuevas tecnologías y la ventaja más valorada del uso de las TIC fue el acceso rápido a la información. Los profesores perciben que tras la Declaración de Bolonia, que exige modificar sus procesos de enseñanza-aprendizaje mediante las nuevas metodologías docentes, se ha producido un descenso en el rendimiento propio y en el de sus compañeros de área de conocimiento. Conclusión. El profesorado de enfermería está afrontando con esfuerzo los nuevos retos que las TIC plantean para formar a los profesionales del siglo XXI. Es fundamental prestar especial atención al mejoramiento de las competencias en manejo de TIC...

Objective. This work sought to analyze the use of Information and Communication Technologies (ICTs) and social networks among the university nursing faculty staff in Spain. Methodology. This was a descriptive, cross-sectional study using a questionnaire on ICT skills designed to comply with the research objective, which was evaluated by experts and which was subjected to exploratory analysis of principal components; the reliability of this instrument measured with Cronbach’s alpha was 0.85. The information technology tool used to publish the questionnaire on line was Limesurvey. The sample comprised 165 professors from 25 Nursing Faculties and Schools from universities in Spain. Results. Seventy one percent of the total surveyed used internet services to look for information, 63% used the internet as a means for formation and learning, and 72% used it as a communication platform (e-mail and virtual platforms like Sakai and Moodle). Although 51% of the teaching staff surveyed had more than 120 students registered in their courses, hypothesis testing revealed that the number of students in class is not a determining factor for the teaching staff to have greater interest to update its knowledge in ICTs. Younger professors use new technologies more profusely and the most-valued advantage of using ICTs was quick access to information. Professors perceive that after the Bologna Declaration, which requires modifying their teaching-learning processes through the new teaching methodologies, a drop has been produced in their performance and that of their peers in their area of knowledge. Conclusion. The nursing teaching staff is making strong efforts to confront the new challenges posed by ICTs to train the professionals of the 21st century. It is fundamental to pay special attention to improving the university teaching staff’s skills in managing ICTs, promoting the implementation of the knowledge acquired...

Objetivo. Analisar o uso das Tecnologias da informação e a comunicação –TICs- e as redes sociais entre o professorado universitário de enfermagem na Espanha. Metodologia. Estudo descritivo de corte transversal no que se empregou um questionário sobre concorrências TICs desenhado para cumprir com o objetivo de investigação, o qual foi avaliado por experientes e ao que posteriormente se lhe fez análise exploratório de componentes principais; a confiabilidade deste instrumento medida com o alfa de Cronbach foi 0.85. A ferramenta informática utilizada para publicar na linha o questionário foi Limesurvey. A amostra esteve composta por 165 professores de 25 Faculdades e Escolas de Enfermagem das Universidades da Espanha. Resultados. 71% do total de interrogados utilizava os serviços de Internet para procurar informação, 63% fazia uso de internet como via de formação e aprendizagem e um 72% o empregava como plataforma de comunicação (correio eletrônico e plataformas virtuais como Sakai e Moodle). Apesar de que 51% do professorado interrogado tinha mais de 120 alunos matriculados em seus cursos, um contraste de hipótese revelou que o número de alunos em classe não é um fator determinante para que o professorado tenha maior interesse por atualizar seus conhecimentos em TICs. Os professores mais jovens utilizam com maior profusão as novas tecnologias e a vantagem mais valorizada do uso das TICs foi o acesso rápido à informação. Os professores percebem que depois da Declaração de Bologna, que exige modificar seus processos de ensino-aprendizagem mediante as novas metodologias docentes, produziu-se um descenso no rendimento próprio e no de seus colegas da área de conhecimento. Conclusão. O professorado de enfermagem está enfrentado com esforço os novos reptos que as TICs propõem para formar aos profissionais do século XXI. É fundamental prestar especial atendimento ao melhoramento as concorrências em manejo de TICs do professorado universitário...

[Immigrant women care in a health intercultural mediation program]. / Atención a mujeres inmigrantes en un programa de mediación intercultural en salud.

BACKGROUND: Intercultural Mediation is a strategy for quality health care aimed at reducing inequalities in immigrant population. The aim is to analyse main reasons consultation with the mediation service, women care profile and characteristics of intervention. METHODS: Cross-sectional study of 339 episodes of care by two intercultural mediators (MI) from February 2008 to October 2011 in Valencia. Variables were analysed individual records of the consultations of the MI: reasons for referral to MI and professionals who refer, motives and problems identified by MI, kind of intervention, kind of derivation of MI and socio-economic variables. To evaluate the differences between countries, X2 test was used for qualitative variables and one-way ANOVA test for quantitative variables. RESULTS: 123 women (36,3%), were referred to the MI by the Sexual and Reproductive Health Centre and 98 (28,9%) by the midwife. 272 women (80,24%) were referred for information and demand for contraception. The MI conducted health education and detected social problems in 67 women (19,7%) and gender violence in 38 (11,21%). CONCLUSIONS: The women attending were Latin American immigrants (those of Bolivia showed more vulnerability) and were referred for contraception. The MI provided information, education and facilitated access to reproductive health services. Bolivian women showed more vulnerability factors: irregular situation, precarious work and low residence time.

[Perinatal outcomes after prenatal ultrasound diagnosis of persistence of right umbilical vein]. / Resultados perinatales tras el diagnóstico ecográfico prenatal de vena umbilical derecha persistente.

OBJECTIVE: To describe the ultrasound findings, maternal and perinatal variables in cases with a prenatal diagnosis of persistence of right umbilical vein. PATIENTS AND METHODS: A descriptive analysis of cases with prenatal diagnosis of persistence of right umbilical vein in the Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitario Severo Ochoa. We described ultrasound findings, maternal and perinatal variables. RESULTS: We explored 9198 fetuses and 6 cases (0.06%) were diagnosis prenatally of persistent right umbilical vein, between 20 and 29 weeks of gestation. The male/female ratio was 1/1. Ductus venosus was presented in all cases. Two fetuses (33%) were proved to have other structural anomalies and their parents opted for termination of the pregnancy. All cases had no chromosomal anomaly associated and after birth, neonatal developments were favorable. CONCLUSION: Based on our results and a literature review, after prenatal diagnosis of persistent right umbilical vein, an exhaustive morphological study, which included a fetal echocardiography, is mandatory in order to rule out other structural malformations. Indication for fetal karyotype study has to be individualized considering persistence right umbilical vein type and other ultrasound findings.

[Fetal ovarian cyst: prenatal diagnosis, perinatal outcome and treatment. Case series and literature review]. / Quiste de ovario fetal: diagnóstico prenatal, evolución perinatal y tratamiento. Serie de casos y revisión de la bibliografía.

BACKGROUND: Ovarian cysts in fetal abdominal tumors are more frequently diagnosed during pregnancy. Most of the time are usually small, asymptomatic and resolve spontaneously during pregnancy or in early neonatal life. OBJECTIVE: To describe the clinical and ultrasound cases with prenatal diagnosis of ovarian cyst treated in our center between 2002 and 2005. MATERIAL AND METHODS: Descriptive and observational cases of fetal ovarian cyst diagnosedbefore birth. The variables maternal and perinatal most relevant clinical data obtained at diagnosis and after birth. RESULTS: We explored 9.198 fetuses, of which there were 10 cases of ovarian cyst diagnosed between the second and third trimesters of pregnancy. All cases were unilateral andsonographic appearance homogeneous. In four cases there was spontaneous disappearance during the remaining gestational period. In the other six cases, four missing in the first 12 months and only two image persisted more than a year. CONCLUSIONS: Based on our results and in accordance with the literature, the prenatal diagnosis of fetal ovarian cyst is usually associated with a conservative approach with serialultrasound monitoring to rule out rare serious complications. During the neonatal period spontaneous disappearance is often the case and the surgical approach is indicated in cases with suspected persistent or torsion or hemorrhage, with cystectomy as first choice.

Análisis de la percepción de valores en los alumnos universitarios de enfermería / Analysis of the perception of values in college nursing students

Resumen:

Marco teórico y objetivo: el objetivo del presente trabajo es analizar el sistema de valores que los alumnos perciben, después de una serie de estrategias implantadas en el proceso de enseñanza-aprendizaje en la Escuela Universitaria de Ciencias de la Salud de la Universidad de León, España. Metodología: se aplicó el cuestionario de valores DpV-43 a 145 alumnos. Fue aplicado un análisis descriptivo con medidas de tendencia central, medias y moda. Resultado: los alumnos consideraron que el principal valor que debía liderar la vida universitaria era el compañerismo-cooperación. Discusión: los autores proponen estrategias en el proceso de enseñanza-aprendizaje para promover la cooperación y la cohesión entre los estudiantes, promoviendo redes de transferencia de conocimiento y amistad entre las Escuelas de Enfermería.

Development and characterization of microsatellite markers for the Cape gooseberry Physalis peruviana.

Physalis peruviana, commonly known as Cape gooseberry, is an Andean Solanaceae fruit with high nutritional value and interesting medicinal properties. In the present study we report the development and characterization of microsatellite loci from a P. peruviana commercial Colombian genotype. We identified 932 imperfect and 201 perfect Simple Sequence Repeats (SSR) loci in untranslated regions (UTRs) and 304 imperfect and 83 perfect SSR loci in coding regions from the assembled Physalis peruviana leaf transcriptome. The UTR SSR loci were used for the development of 162 primers for amplification. The efficiency of these primers was tested via PCR in a panel of seven P. peruviana accessions including Colombia, Kenya and Ecuador ecotypes and one closely related species Physalis floridana. We obtained an amplification rate of 83% and a polymorphic rate of 22%. Here we report the first P. peruviana specific microsatellite set, a valuable tool for a wide variety of applications, including functional diversity, conservation and improvement of the species.